Question:
> It is comforting to know > that "out there" there are people who understand about the sick lurch in the > stomach and the overwhelming grief when, over and over again, you realise > you will never see your beloved cat again; people who do not think that it > is ridiculous or silly to love an animal so much that you mourn for them as > you would a human. Jayge was a constant delight and I doted on him.
My God yes, Kate. There most certainly are such individuals Your love for Jayge is touching, and a genuine inspiration. People who cannot understand the feeling never will. They are lost souls, you can do nothing to change them. Let them go. It would take untold thousands of souls who don’t believe to equal one that does. You are amongst friends here. We all understand and see how genuinely deep is your love for Jayge. We truly feel your loss and feel the pain you are enduring, You are among friends. You can trust us all. Paul
Response:
Please don`t apologise for giving all the technical data regarding diabetes, Phil. I am one of those people with a need to know "why". This is one of the reasons for my being so bitter about J.J.`s death. I had to keep asking for what little information I was given by the vet. I even had to ask if he had eaten or had a pee! Both very important in a sick animal. On one occasion I noticed that he didn`t have a water dish in his cage, and asked if there was a reason. There wasn`t – it was an oversight…. Anyway, I could go on and on about what I see as the failings of the surgery and will end up being a bore, so I won`t. I _would_ like to say how grateful I am for all the messages of condolences. It is comforting to know that "out there" there are people who understand about the sick lurch in the stomach and the overwhelming grief when, over and over again, you realise you will never see your beloved cat again; people who do not think that it is ridiculous or silly to love an animal so much that you mourn for them as you would a human. Jayge was a constant delight and I doted on him. Kate
Response:
– Hide quoted text — Show quoted text -> To be fair, the vet who took J.J.`s blood samples did tell me that the high > glucose levels could be due to stress, but I was told at that point that no > further samples would be taken because he was so poorly. However, I do not > know if any samples _were_ taken on a later date, as nothing showed on his > notes – which I suspect were incomplete anyway. > To be even more scrupulously fair, when I took Jayge back to surgery after > the initial consultation, I saw the senior vet and he did mention the > possibility of a blood clot, but did not elaborate then or later. Indeed, > when I told the other vet about this the next day, it was the first she had > heard of the suggestion. It did not appear to have occurred to her up to > that point and I do not know if she agreed with that diagnosis. Although I > asked for more tests to be carried out, the response was that Jayge was > either too ill to withstand them, or the equipment was not available at the > surgery. I asked if they could direct me to somewhere where there was such > equipment, but was again told that until, or unless, J.J. showed an > improvement, there was little point. Hence my earlier comment about there > being an apparent casual acceptance that he would die. On Tuesday > afternoon, I gave him a "blanket bath" and while I was drying him off, he > shook his paralysed paw – twice. Also, as I re-arranged that arm when he > was back in his cage, I gently rubbed his wrist and he turned to look at > what I was doing and pulled his arm away – again, twice. So, if it was a > blood clot paralysing his paw, and the clot started to break up,
A very strong possibility. About 50% of cats that are not treated definitively will regain all or most limb motor function within 1 to 6 weeks . The return of function in this situation is due to the cat’s own fibrinolytic system disrupting the thromboembolus. The degree and rapidity of the dissolution depend on the activity of a particular cat’s fibrinolytic system and the size of the thromboembolus. I believe your theory is correct. (JR: back me up on this) some > sensation could have returned, but meanwhile perhaps part of that clot found > its way to his heart.
If it was a clot, I don’t think the clot would find its way to his heart; that’s where it most likely came from. The left atrium is usually the site of thrombus formation. It doesn’t take major surgery or rocket science to determine the extent of occlusion, a nail can be cut back to the "quick" to determine whether bleeding occurs. Cats with severely compromised flow will have a small amount of black-colored blood ooze from their cut nail. I don`t know if that is a possibility. I do believe > that the lack of communication between vets may have contributed towards > J.J.`s death, and having read Phil`s sensitive and most informative post > (for which my thanks)
I am more convinced than ever that he died of insulin > shock.
So am I – but I think there’s more to this tragedy just insulin shock. I think several mistakes were made to correct the first one. Giving a nondiabetic cat insulin can cause severe hyp-o-glycemia. One aspect of the cat’s survival ability is its compensation for severe hypoglycemia. This is termed rebound hyperglycemia or the infamous "Somogyi Overswing". The following events occur when the blood glucose drops very low in a cat (which would occur if a nondiabetic cat was given insulin): 1. Diabetogenic hormones, epinephrine and glucagon, are released. These hormones promote gluconeogenesis and glycogenolysis in the liver and decrease the utilization of glucose by peripheral tissue. 2. The blood glucose level rises rapidly. At this point, they may have given him *more* insulin! 3. Cortisol and growth hormone are released, which further increase the production of and release of glucose. 4. The blood glucose level increases even more rapidly. Again, when no decline in blood glucose was noticed, but a rapid rise, they may have given him *even more* insulin! Since he was not diabetic, his own insulin production was in full production- this, in addition, to what amounts to a massive insulin overdose, is what I believe killed JJ. Following the blood glucose levels for a few more hours without giving insulin, would have allowed them to determine if the rise was pathological or physiological. Of course, this is only a theory and I seriously doubt any of this would be in his chart. I’m very, very sorry for explaining all this, its bad enough that he probably died needlessly, but to shroud his death in, what I believe, is a lie, to me, is intolerable. Its not good enough to just stop using those vets, you should let as many people as possible know your experience – and suspicions. Its true you cannot bring JJ back, but perhaps you can prevent another or several cats from suffering the same fate. That would indeed be a fitting tribute. Please accept my apologies and sympathies. Phil. – Hide quoted text — Show quoted text -> Whilst I realise that nothing I do or say will bring J.J. back, I feel so > angry that I have lost someone very dear to me under such circumstances, and > perhaps unnecessarily. > My thanks for all your kind thoughts. > Kate
Response:
Deepest sympathy to you, Kate. Anne – Hide quoted text — Show quoted text – > (very sad snip) > This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
Kate, I’m very sorry about J.J. and the circumstances surrounding his death. Although you have grieving to do for your little guy now, it sounds to me from what you said that there was negligence involved here and I would pursue it at some point in the near future when you feel up to it. True, it won’t help your little J.J. but something is amiss here. J.J. is happy at the Rainbow Bridge now and will meet you again one day. Sorry. Candace (take the litter out before replying by e-mail)
Response:
Kate, I’m so very sorry to hear of JJ’s passing. It was obvious that you loved and cared for your friend. You will be together at the Rainbow Bridge sometime later. Peace to your heart. Charleen —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–
Response:
To be fair, the vet who took J.J.`s blood samples did tell me that the high glucose levels could be due to stress, but I was told at that point that no further samples would be taken because he was so poorly. However, I do not know if any samples _were_ taken on a later date, as nothing showed on his notes – which I suspect were incomplete anyway. To be even more scrupulously fair, when I took Jayge back to surgery after the initial consultation, I saw the senior vet and he did mention the possibility of a blood clot, but did not elaborate then or later. Indeed, when I told the other vet about this the next day, it was the first she had heard of the suggestion. It did not appear to have occurred to her up to that point and I do not know if she agreed with that diagnosis. Although I asked for more tests to be carried out, the response was that Jayge was either too ill to withstand them, or the equipment was not available at the surgery. I asked if they could direct me to somewhere where there was such equipment, but was again told that until, or unless, J.J. showed an improvement, there was little point. Hence my earlier comment about there being an apparent casual acceptance that he would die. On Tuesday afternoon, I gave him a "blanket bath" and while I was drying him off, he shook his paralysed paw – twice. Also, as I re-arranged that arm when he was back in his cage, I gently rubbed his wrist and he turned to look at what I was doing and pulled his arm away – again, twice. So, if it was a blood clot paralysing his paw, and the clot started to break up, some sensation could have returned, but meanwhile perhaps part of that clot found its way to his heart. I don`t know if that is a possibility. I do believe that the lack of communication between vets may have contributed towards J.J.`s death, and having read Phil`s sensitive and most informative post (for which my thanks) I am more convinced than ever that he died of insulin shock. Whilst I realise that nothing I do or say will bring J.J. back, I feel so angry that I have lost someone very dear to me under such circumstances, and perhaps unnecessarily. My thanks for all your kind thoughts. Kate
Response:
Kate, I am sorry to hear about J.J. You have my condolences. Sue – Hide quoted text — Show quoted text – > About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I’m very sorry about the loss of JJ… especially under such questioning circumstances… Kelly — **When in doubt, see your vet – Nothing else substitutes for a professional!** .
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I suggest you get a copy of the complete medical records to determine exactly what went on. From you account of the sequence of events, sounds to me like neither vet knew what the other was doing. As far as your theory of insulin shock… could be. Its a reasonable theory. I think its safe to say that most, if not every vet who went to a school in the civilized world is well aware of feline stress hyperglycemia – perhaps these two missed that class. A mere office visit is enough to cause physiologic hyperglycemia — even the stress of the needle to draw the blood to test for hyperglycemia can cause hyperglycemia! When a cat senses danger, a chain of physiologic events occurs to prepare for self-preservation. Stress, fear-induced or otherwise, and excitement cause the release of epinephrine, resulting in a sudden release of glucose from the liver and a simultaneous inhibition of insulin at the cellular level which can send glucose levels soaring. JJ was obviously stressed from his medical condition and that stress was further compounded by hospitalization, different environment and additional punctures required for blood tests. To be diagnosed with DM, the diabetic cat should be *persistently* hyperglycemic, with a fasting blood glucose greater than 200 mg/dL, *and* have glucosuria. The absence of glucosuria in an acutely stressed cat signals stress-induced transient hyperglycemia instead of DM. In addition to hyperglycemia and glusosuria, the cat’s history must reveal at least *three* of the four typical signs of polydipisia, polyuria, polyphagia, and weight loss. You did not mention *one*. Based on your information and my understanding of feline hyperglycemia, I can say, with reasonable confidence, that your theory of insulin shock is well within the realm of possibility if not probability. Regarding JJ’s original "injury", I’m not so sure it was in fact an injury. To even consider, let alone mention, the possibility of amputation without extensive diagnostics, or at very least, an x-ray, to my mind is unethical, unprofessional and bordering on incompetency! Could have been a strain, sprain or hairline fracture. However, a 13 y/o male cat is in the risk category for myocardial disease, in which case an aortic thromboembolism is a possibility. Although most thrombi are commonly found in the rear, they can travel through the bloodstream and lodge anywhere in the body so as to obstruct or occlude a blood vessel. Based on your description of these "vets", I seriously doubt this possibility was even considered, nor was he even examined for heart disease. I’m sorry for you loss, *especially* since I believe it was an *unnecessary* loss. Cases of gross negligence and/or incompetency infuriate me. In sympathy, Phil. — "No heaven will not Heaven ever be Unless my cats are there to welcome me" –my epitaph Feline Healthcare: http://maxshouse.com
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I don’t have anything specific regarding JJ’s condition, but I wanted to say how sorry I am for your loss. He was obviously very loved & must have had a wonderful life with you.
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I am sorry to hear about this, I hope you can get some answers that can bring you peace. Sharon
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
About a week ago, I posted regarding the sudden paralysis which occurred to my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve damage. I brought him home on the Monday afternoon as he seemed depressed, but by that evening he was very low so I returned to the vet Tuesday morning. Blood tests were finally taken (from the carotid artery – never seen that before) and although his kidney and liver functions were acceptable, his white blood cell count and glucose levels were very high. He was not expected to last the night. However, he was still hanging on the next day and a urine sample showed high glucose levels, although I was told that this could be the glucose in his blood passing through. By now he was on a saline drip, very cold and miserable. The vet told me that a further blood test would show if he was diabetic, but she wouldn`t do any further tests because he was so poorly. I could not give up on J.J., as I was convinced his condition was treatable if only we could find out what it was. I visited every day and he developed oedema all over (I was subsequently told he was given too much saline solution…) but sometimes he would be quite bright, although very weak. Sometimes he would eat a little, other times he had to be force fed. By the Friday we thought it was all over, but I just couldn`t sign the consent form for euthanasia. We were going to bring him home on the Saturday, but he showed definite signs of improvement Friday evening, slight but encouraging, and the senior vet advised us to leave him in hospital as the stress of changing his environment might set him back again. On Monday when I visited, J.J. was very much better, although he still wouldn`t eat. His oedema had almost gone, his breathing was less laboured and he was able to totter around a little and showed an interest in what was going on. I noticed on his notes that insulin had been prescribed and assumed further tests had revealed he had diabetes. However, when I asked the vet about this, she didn`t know. The senior vet had instructed her to give him insulin and she assumed that J.J. had already been given some the previous day when she wasn`t on duty. There seems to have been a lack of consultation between both vets, and I suggested that she talk it over with the other vet. She did seem doubtful as to the wisdom of giving J.J. insulin as he wasn`t eating very much. Still, it seems as if she decided to go ahead anyway, because she gave Jayge a little insulin that evening, having thought he had eaten sufficient (how did she know how much he had eaten? she hadn`t seen it with her own eyes and just had the nurse`s say-so). This morning we had a call to say Jayge had died during the night. We still do not know what was really wrong with Jayge. All I get is a very general diagnosis of system failure. I suggested insulin shock and the vet didn`t totally dismiss it, but seemed unconcerned. I did not want him opened up for a post mortem, and even if we insisted on one, it is doubtful if it would show anything definite as I was told he didn`t seem to have any obvious tumours, for example. His lungs were clear, his heartbeat strong and regular. His kidneys were functioning OK. I am not accusing the surgery of lack of care or negligence but I got the impression that there was a certain casual acceptance that J.J. was going to die and they were going through the motions. I shall always believe that he died of insulin shock but if I ask why did they give it to him if they didn`t know for sure if he was diabetic (there were no notes to suggest this), I am quite sure that I would be told that tests had been carried out, but the results hadn`t been written down. It is all most unsatisfactory and unsettling and I feel very bitter. J.J. was my dearest little chap and I shall miss him dreadfully. He was so very special – everybody loved J.J. and he loved everybody right back Kate P.S. I will be changing my vet…
Response:
> It is comforting to know > that "out there" there are people who understand about the sick lurch in the > stomach and the overwhelming grief when, over and over again, you realise > you will never see your beloved cat again; people who do not think that it > is ridiculous or silly to love an animal so much that you mourn for them as > you would a human. Jayge was a constant delight and I doted on him.
My God yes, Kate. There most certainly are such individuals Your love for Jayge is touching, and a genuine inspiration. People who cannot understand the feeling never will. They are lost souls, you can do nothing to change them. Let them go. It would take untold thousands of souls who don’t believe to equal one that does. You are amongst friends here. We all understand and see how genuinely deep is your love for Jayge. We truly feel your loss and feel the pain you are enduring, You are among friends. You can trust us all. Paul
Response:
Please don`t apologise for giving all the technical data regarding diabetes, Phil. I am one of those people with a need to know "why". This is one of the reasons for my being so bitter about J.J.`s death. I had to keep asking for what little information I was given by the vet. I even had to ask if he had eaten or had a pee! Both very important in a sick animal. On one occasion I noticed that he didn`t have a water dish in his cage, and asked if there was a reason. There wasn`t – it was an oversight…. Anyway, I could go on and on about what I see as the failings of the surgery and will end up being a bore, so I won`t. I _would_ like to say how grateful I am for all the messages of condolences. It is comforting to know that "out there" there are people who understand about the sick lurch in the stomach and the overwhelming grief when, over and over again, you realise you will never see your beloved cat again; people who do not think that it is ridiculous or silly to love an animal so much that you mourn for them as you would a human. Jayge was a constant delight and I doted on him. Kate
Response:
– Hide quoted text — Show quoted text -> To be fair, the vet who took J.J.`s blood samples did tell me that the high > glucose levels could be due to stress, but I was told at that point that no > further samples would be taken because he was so poorly. However, I do not > know if any samples _were_ taken on a later date, as nothing showed on his > notes – which I suspect were incomplete anyway. > To be even more scrupulously fair, when I took Jayge back to surgery after > the initial consultation, I saw the senior vet and he did mention the > possibility of a blood clot, but did not elaborate then or later. Indeed, > when I told the other vet about this the next day, it was the first she had > heard of the suggestion. It did not appear to have occurred to her up to > that point and I do not know if she agreed with that diagnosis. Although I > asked for more tests to be carried out, the response was that Jayge was > either too ill to withstand them, or the equipment was not available at the > surgery. I asked if they could direct me to somewhere where there was such > equipment, but was again told that until, or unless, J.J. showed an > improvement, there was little point. Hence my earlier comment about there > being an apparent casual acceptance that he would die. On Tuesday > afternoon, I gave him a "blanket bath" and while I was drying him off, he > shook his paralysed paw – twice. Also, as I re-arranged that arm when he > was back in his cage, I gently rubbed his wrist and he turned to look at > what I was doing and pulled his arm away – again, twice. So, if it was a > blood clot paralysing his paw, and the clot started to break up,
A very strong possibility. About 50% of cats that are not treated definitively will regain all or most limb motor function within 1 to 6 weeks . The return of function in this situation is due to the cat’s own fibrinolytic system disrupting the thromboembolus. The degree and rapidity of the dissolution depend on the activity of a particular cat’s fibrinolytic system and the size of the thromboembolus. I believe your theory is correct. (JR: back me up on this) some > sensation could have returned, but meanwhile perhaps part of that clot found > its way to his heart.
If it was a clot, I don’t think the clot would find its way to his heart; that’s where it most likely came from. The left atrium is usually the site of thrombus formation. It doesn’t take major surgery or rocket science to determine the extent of occlusion, a nail can be cut back to the "quick" to determine whether bleeding occurs. Cats with severely compromised flow will have a small amount of black-colored blood ooze from their cut nail. I don`t know if that is a possibility. I do believe > that the lack of communication between vets may have contributed towards > J.J.`s death, and having read Phil`s sensitive and most informative post > (for which my thanks)
I am more convinced than ever that he died of insulin > shock.
So am I – but I think there’s more to this tragedy just insulin shock. I think several mistakes were made to correct the first one. Giving a nondiabetic cat insulin can cause severe hyp-o-glycemia. One aspect of the cat’s survival ability is its compensation for severe hypoglycemia. This is termed rebound hyperglycemia or the infamous "Somogyi Overswing". The following events occur when the blood glucose drops very low in a cat (which would occur if a nondiabetic cat was given insulin): 1. Diabetogenic hormones, epinephrine and glucagon, are released. These hormones promote gluconeogenesis and glycogenolysis in the liver and decrease the utilization of glucose by peripheral tissue. 2. The blood glucose level rises rapidly. At this point, they may have given him *more* insulin! 3. Cortisol and growth hormone are released, which further increase the production of and release of glucose. 4. The blood glucose level increases even more rapidly. Again, when no decline in blood glucose was noticed, but a rapid rise, they may have given him *even more* insulin! Since he was not diabetic, his own insulin production was in full production- this, in addition, to what amounts to a massive insulin overdose, is what I believe killed JJ. Following the blood glucose levels for a few more hours without giving insulin, would have allowed them to determine if the rise was pathological or physiological. Of course, this is only a theory and I seriously doubt any of this would be in his chart. I’m very, very sorry for explaining all this, its bad enough that he probably died needlessly, but to shroud his death in, what I believe, is a lie, to me, is intolerable. Its not good enough to just stop using those vets, you should let as many people as possible know your experience – and suspicions. Its true you cannot bring JJ back, but perhaps you can prevent another or several cats from suffering the same fate. That would indeed be a fitting tribute. Please accept my apologies and sympathies. Phil. – Hide quoted text — Show quoted text -> Whilst I realise that nothing I do or say will bring J.J. back, I feel so > angry that I have lost someone very dear to me under such circumstances, and > perhaps unnecessarily. > My thanks for all your kind thoughts. > Kate
Response:
Deepest sympathy to you, Kate. Anne – Hide quoted text — Show quoted text – > (very sad snip) > This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
Kate, I’m very sorry about J.J. and the circumstances surrounding his death. Although you have grieving to do for your little guy now, it sounds to me from what you said that there was negligence involved here and I would pursue it at some point in the near future when you feel up to it. True, it won’t help your little J.J. but something is amiss here. J.J. is happy at the Rainbow Bridge now and will meet you again one day. Sorry. Candace (take the litter out before replying by e-mail)
Response:
Kate, I’m so very sorry to hear of JJ’s passing. It was obvious that you loved and cared for your friend. You will be together at the Rainbow Bridge sometime later. Peace to your heart. Charleen —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–
Response:
To be fair, the vet who took J.J.`s blood samples did tell me that the high glucose levels could be due to stress, but I was told at that point that no further samples would be taken because he was so poorly. However, I do not know if any samples _were_ taken on a later date, as nothing showed on his notes – which I suspect were incomplete anyway. To be even more scrupulously fair, when I took Jayge back to surgery after the initial consultation, I saw the senior vet and he did mention the possibility of a blood clot, but did not elaborate then or later. Indeed, when I told the other vet about this the next day, it was the first she had heard of the suggestion. It did not appear to have occurred to her up to that point and I do not know if she agreed with that diagnosis. Although I asked for more tests to be carried out, the response was that Jayge was either too ill to withstand them, or the equipment was not available at the surgery. I asked if they could direct me to somewhere where there was such equipment, but was again told that until, or unless, J.J. showed an improvement, there was little point. Hence my earlier comment about there being an apparent casual acceptance that he would die. On Tuesday afternoon, I gave him a "blanket bath" and while I was drying him off, he shook his paralysed paw – twice. Also, as I re-arranged that arm when he was back in his cage, I gently rubbed his wrist and he turned to look at what I was doing and pulled his arm away – again, twice. So, if it was a blood clot paralysing his paw, and the clot started to break up, some sensation could have returned, but meanwhile perhaps part of that clot found its way to his heart. I don`t know if that is a possibility. I do believe that the lack of communication between vets may have contributed towards J.J.`s death, and having read Phil`s sensitive and most informative post (for which my thanks) I am more convinced than ever that he died of insulin shock. Whilst I realise that nothing I do or say will bring J.J. back, I feel so angry that I have lost someone very dear to me under such circumstances, and perhaps unnecessarily. My thanks for all your kind thoughts. Kate
Response:
Kate, I am sorry to hear about J.J. You have my condolences. Sue – Hide quoted text — Show quoted text – > About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I’m very sorry about the loss of JJ… especially under such questioning circumstances… Kelly — **When in doubt, see your vet – Nothing else substitutes for a professional!** .
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I suggest you get a copy of the complete medical records to determine exactly what went on. From you account of the sequence of events, sounds to me like neither vet knew what the other was doing. As far as your theory of insulin shock… could be. Its a reasonable theory. I think its safe to say that most, if not every vet who went to a school in the civilized world is well aware of feline stress hyperglycemia – perhaps these two missed that class. A mere office visit is enough to cause physiologic hyperglycemia — even the stress of the needle to draw the blood to test for hyperglycemia can cause hyperglycemia! When a cat senses danger, a chain of physiologic events occurs to prepare for self-preservation. Stress, fear-induced or otherwise, and excitement cause the release of epinephrine, resulting in a sudden release of glucose from the liver and a simultaneous inhibition of insulin at the cellular level which can send glucose levels soaring. JJ was obviously stressed from his medical condition and that stress was further compounded by hospitalization, different environment and additional punctures required for blood tests. To be diagnosed with DM, the diabetic cat should be *persistently* hyperglycemic, with a fasting blood glucose greater than 200 mg/dL, *and* have glucosuria. The absence of glucosuria in an acutely stressed cat signals stress-induced transient hyperglycemia instead of DM. In addition to hyperglycemia and glusosuria, the cat’s history must reveal at least *three* of the four typical signs of polydipisia, polyuria, polyphagia, and weight loss. You did not mention *one*. Based on your information and my understanding of feline hyperglycemia, I can say, with reasonable confidence, that your theory of insulin shock is well within the realm of possibility if not probability. Regarding JJ’s original "injury", I’m not so sure it was in fact an injury. To even consider, let alone mention, the possibility of amputation without extensive diagnostics, or at very least, an x-ray, to my mind is unethical, unprofessional and bordering on incompetency! Could have been a strain, sprain or hairline fracture. However, a 13 y/o male cat is in the risk category for myocardial disease, in which case an aortic thromboembolism is a possibility. Although most thrombi are commonly found in the rear, they can travel through the bloodstream and lodge anywhere in the body so as to obstruct or occlude a blood vessel. Based on your description of these "vets", I seriously doubt this possibility was even considered, nor was he even examined for heart disease. I’m sorry for you loss, *especially* since I believe it was an *unnecessary* loss. Cases of gross negligence and/or incompetency infuriate me. In sympathy, Phil. — "No heaven will not Heaven ever be Unless my cats are there to welcome me" –my epitaph Feline Healthcare: http://maxshouse.com
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I don’t have anything specific regarding JJ’s condition, but I wanted to say how sorry I am for your loss. He was obviously very loved & must have had a wonderful life with you.
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I am sorry to hear about this, I hope you can get some answers that can bring you peace. Sharon
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
About a week ago, I posted regarding the sudden paralysis which occurred to my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve damage. I brought him home on the Monday afternoon as he seemed depressed, but by that evening he was very low so I returned to the vet Tuesday morning. Blood tests were finally taken (from the carotid artery – never seen that before) and although his kidney and liver functions were acceptable, his white blood cell count and glucose levels were very high. He was not expected to last the night. However, he was still hanging on the next day and a urine sample showed high glucose levels, although I was told that this could be the glucose in his blood passing through. By now he was on a saline drip, very cold and miserable. The vet told me that a further blood test would show if he was diabetic, but she wouldn`t do any further tests because he was so poorly. I could not give up on J.J., as I was convinced his condition was treatable if only we could find out what it was. I visited every day and he developed oedema all over (I was subsequently told he was given too much saline solution…) but sometimes he would be quite bright, although very weak. Sometimes he would eat a little, other times he had to be force fed. By the Friday we thought it was all over, but I just couldn`t sign the consent form for euthanasia. We were going to bring him home on the Saturday, but he showed definite signs of improvement Friday evening, slight but encouraging, and the senior vet advised us to leave him in hospital as the stress of changing his environment might set him back again. On Monday when I visited, J.J. was very much better, although he still wouldn`t eat. His oedema had almost gone, his breathing was less laboured and he was able to totter around a little and showed an interest in what was going on. I noticed on his notes that insulin had been prescribed and assumed further tests had revealed he had diabetes. However, when I asked the vet about this, she didn`t know. The senior vet had instructed her to give him insulin and she assumed that J.J. had already been given some the previous day when she wasn`t on duty. There seems to have been a lack of consultation between both vets, and I suggested that she talk it over with the other vet. She did seem doubtful as to the wisdom of giving J.J. insulin as he wasn`t eating very much. Still, it seems as if she decided to go ahead anyway, because she gave Jayge a little insulin that evening, having thought he had eaten sufficient (how did she know how much he had eaten? she hadn`t seen it with her own eyes and just had the nurse`s say-so). This morning we had a call to say Jayge had died during the night. We still do not know what was really wrong with Jayge. All I get is a very general diagnosis of system failure. I suggested insulin shock and the vet didn`t totally dismiss it, but seemed unconcerned. I did not want him opened up for a post mortem, and even if we insisted on one, it is doubtful if it would show anything definite as I was told he didn`t seem to have any obvious tumours, for example. His lungs were clear, his heartbeat strong and regular. His kidneys were functioning OK. I am not accusing the surgery of lack of care or negligence but I got the impression that there was a certain casual acceptance that J.J. was going to die and they were going through the motions. I shall always believe that he died of insulin shock but if I ask why did they give it to him if they didn`t know for sure if he was diabetic (there were no notes to suggest this), I am quite sure that I would be told that tests had been carried out, but the results hadn`t been written down. It is all most unsatisfactory and unsettling and I feel very bitter. J.J. was my dearest little chap and I shall miss him dreadfully. He was so very special – everybody loved J.J. and he loved everybody right back Kate P.S. I will be changing my vet…
Response:
> It is comforting to know > that "out there" there are people who understand about the sick lurch in the > stomach and the overwhelming grief when, over and over again, you realise > you will never see your beloved cat again; people who do not think that it > is ridiculous or silly to love an animal so much that you mourn for them as > you would a human. Jayge was a constant delight and I doted on him.
My God yes, Kate. There most certainly are such individuals Your love for Jayge is touching, and a genuine inspiration. People who cannot understand the feeling never will. They are lost souls, you can do nothing to change them. Let them go. It would take untold thousands of souls who don’t believe to equal one that does. You are amongst friends here. We all understand and see how genuinely deep is your love for Jayge. We truly feel your loss and feel the pain you are enduring, You are among friends. You can trust us all. Paul
Response:
Please don`t apologise for giving all the technical data regarding diabetes, Phil. I am one of those people with a need to know "why". This is one of the reasons for my being so bitter about J.J.`s death. I had to keep asking for what little information I was given by the vet. I even had to ask if he had eaten or had a pee! Both very important in a sick animal. On one occasion I noticed that he didn`t have a water dish in his cage, and asked if there was a reason. There wasn`t – it was an oversight…. Anyway, I could go on and on about what I see as the failings of the surgery and will end up being a bore, so I won`t. I _would_ like to say how grateful I am for all the messages of condolences. It is comforting to know that "out there" there are people who understand about the sick lurch in the stomach and the overwhelming grief when, over and over again, you realise you will never see your beloved cat again; people who do not think that it is ridiculous or silly to love an animal so much that you mourn for them as you would a human. Jayge was a constant delight and I doted on him. Kate
Response:
– Hide quoted text — Show quoted text -> To be fair, the vet who took J.J.`s blood samples did tell me that the high > glucose levels could be due to stress, but I was told at that point that no > further samples would be taken because he was so poorly. However, I do not > know if any samples _were_ taken on a later date, as nothing showed on his > notes – which I suspect were incomplete anyway. > To be even more scrupulously fair, when I took Jayge back to surgery after > the initial consultation, I saw the senior vet and he did mention the > possibility of a blood clot, but did not elaborate then or later. Indeed, > when I told the other vet about this the next day, it was the first she had > heard of the suggestion. It did not appear to have occurred to her up to > that point and I do not know if she agreed with that diagnosis. Although I > asked for more tests to be carried out, the response was that Jayge was > either too ill to withstand them, or the equipment was not available at the > surgery. I asked if they could direct me to somewhere where there was such > equipment, but was again told that until, or unless, J.J. showed an > improvement, there was little point. Hence my earlier comment about there > being an apparent casual acceptance that he would die. On Tuesday > afternoon, I gave him a "blanket bath" and while I was drying him off, he > shook his paralysed paw – twice. Also, as I re-arranged that arm when he > was back in his cage, I gently rubbed his wrist and he turned to look at > what I was doing and pulled his arm away – again, twice. So, if it was a > blood clot paralysing his paw, and the clot started to break up,
A very strong possibility. About 50% of cats that are not treated definitively will regain all or most limb motor function within 1 to 6 weeks . The return of function in this situation is due to the cat’s own fibrinolytic system disrupting the thromboembolus. The degree and rapidity of the dissolution depend on the activity of a particular cat’s fibrinolytic system and the size of the thromboembolus. I believe your theory is correct. (JR: back me up on this) some > sensation could have returned, but meanwhile perhaps part of that clot found > its way to his heart.
If it was a clot, I don’t think the clot would find its way to his heart; that’s where it most likely came from. The left atrium is usually the site of thrombus formation. It doesn’t take major surgery or rocket science to determine the extent of occlusion, a nail can be cut back to the "quick" to determine whether bleeding occurs. Cats with severely compromised flow will have a small amount of black-colored blood ooze from their cut nail. I don`t know if that is a possibility. I do believe > that the lack of communication between vets may have contributed towards > J.J.`s death, and having read Phil`s sensitive and most informative post > (for which my thanks)
I am more convinced than ever that he died of insulin > shock.
So am I – but I think there’s more to this tragedy just insulin shock. I think several mistakes were made to correct the first one. Giving a nondiabetic cat insulin can cause severe hyp-o-glycemia. One aspect of the cat’s survival ability is its compensation for severe hypoglycemia. This is termed rebound hyperglycemia or the infamous "Somogyi Overswing". The following events occur when the blood glucose drops very low in a cat (which would occur if a nondiabetic cat was given insulin): 1. Diabetogenic hormones, epinephrine and glucagon, are released. These hormones promote gluconeogenesis and glycogenolysis in the liver and decrease the utilization of glucose by peripheral tissue. 2. The blood glucose level rises rapidly. At this point, they may have given him *more* insulin! 3. Cortisol and growth hormone are released, which further increase the production of and release of glucose. 4. The blood glucose level increases even more rapidly. Again, when no decline in blood glucose was noticed, but a rapid rise, they may have given him *even more* insulin! Since he was not diabetic, his own insulin production was in full production- this, in addition, to what amounts to a massive insulin overdose, is what I believe killed JJ. Following the blood glucose levels for a few more hours without giving insulin, would have allowed them to determine if the rise was pathological or physiological. Of course, this is only a theory and I seriously doubt any of this would be in his chart. I’m very, very sorry for explaining all this, its bad enough that he probably died needlessly, but to shroud his death in, what I believe, is a lie, to me, is intolerable. Its not good enough to just stop using those vets, you should let as many people as possible know your experience – and suspicions. Its true you cannot bring JJ back, but perhaps you can prevent another or several cats from suffering the same fate. That would indeed be a fitting tribute. Please accept my apologies and sympathies. Phil. – Hide quoted text — Show quoted text -> Whilst I realise that nothing I do or say will bring J.J. back, I feel so > angry that I have lost someone very dear to me under such circumstances, and > perhaps unnecessarily. > My thanks for all your kind thoughts. > Kate
Response:
Deepest sympathy to you, Kate. Anne – Hide quoted text — Show quoted text – > (very sad snip) > This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
Kate, I’m very sorry about J.J. and the circumstances surrounding his death. Although you have grieving to do for your little guy now, it sounds to me from what you said that there was negligence involved here and I would pursue it at some point in the near future when you feel up to it. True, it won’t help your little J.J. but something is amiss here. J.J. is happy at the Rainbow Bridge now and will meet you again one day. Sorry. Candace (take the litter out before replying by e-mail)
Response:
Kate, I’m so very sorry to hear of JJ’s passing. It was obvious that you loved and cared for your friend. You will be together at the Rainbow Bridge sometime later. Peace to your heart. Charleen —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–
Response:
To be fair, the vet who took J.J.`s blood samples did tell me that the high glucose levels could be due to stress, but I was told at that point that no further samples would be taken because he was so poorly. However, I do not know if any samples _were_ taken on a later date, as nothing showed on his notes – which I suspect were incomplete anyway. To be even more scrupulously fair, when I took Jayge back to surgery after the initial consultation, I saw the senior vet and he did mention the possibility of a blood clot, but did not elaborate then or later. Indeed, when I told the other vet about this the next day, it was the first she had heard of the suggestion. It did not appear to have occurred to her up to that point and I do not know if she agreed with that diagnosis. Although I asked for more tests to be carried out, the response was that Jayge was either too ill to withstand them, or the equipment was not available at the surgery. I asked if they could direct me to somewhere where there was such equipment, but was again told that until, or unless, J.J. showed an improvement, there was little point. Hence my earlier comment about there being an apparent casual acceptance that he would die. On Tuesday afternoon, I gave him a "blanket bath" and while I was drying him off, he shook his paralysed paw – twice. Also, as I re-arranged that arm when he was back in his cage, I gently rubbed his wrist and he turned to look at what I was doing and pulled his arm away – again, twice. So, if it was a blood clot paralysing his paw, and the clot started to break up, some sensation could have returned, but meanwhile perhaps part of that clot found its way to his heart. I don`t know if that is a possibility. I do believe that the lack of communication between vets may have contributed towards J.J.`s death, and having read Phil`s sensitive and most informative post (for which my thanks) I am more convinced than ever that he died of insulin shock. Whilst I realise that nothing I do or say will bring J.J. back, I feel so angry that I have lost someone very dear to me under such circumstances, and perhaps unnecessarily. My thanks for all your kind thoughts. Kate
Response:
Kate, I am sorry to hear about J.J. You have my condolences. Sue – Hide quoted text — Show quoted text – > About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I’m very sorry about the loss of JJ… especially under such questioning circumstances… Kelly — **When in doubt, see your vet – Nothing else substitutes for a professional!** .
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I suggest you get a copy of the complete medical records to determine exactly what went on. From you account of the sequence of events, sounds to me like neither vet knew what the other was doing. As far as your theory of insulin shock… could be. Its a reasonable theory. I think its safe to say that most, if not every vet who went to a school in the civilized world is well aware of feline stress hyperglycemia – perhaps these two missed that class. A mere office visit is enough to cause physiologic hyperglycemia — even the stress of the needle to draw the blood to test for hyperglycemia can cause hyperglycemia! When a cat senses danger, a chain of physiologic events occurs to prepare for self-preservation. Stress, fear-induced or otherwise, and excitement cause the release of epinephrine, resulting in a sudden release of glucose from the liver and a simultaneous inhibition of insulin at the cellular level which can send glucose levels soaring. JJ was obviously stressed from his medical condition and that stress was further compounded by hospitalization, different environment and additional punctures required for blood tests. To be diagnosed with DM, the diabetic cat should be *persistently* hyperglycemic, with a fasting blood glucose greater than 200 mg/dL, *and* have glucosuria. The absence of glucosuria in an acutely stressed cat signals stress-induced transient hyperglycemia instead of DM. In addition to hyperglycemia and glusosuria, the cat’s history must reveal at least *three* of the four typical signs of polydipisia, polyuria, polyphagia, and weight loss. You did not mention *one*. Based on your information and my understanding of feline hyperglycemia, I can say, with reasonable confidence, that your theory of insulin shock is well within the realm of possibility if not probability. Regarding JJ’s original "injury", I’m not so sure it was in fact an injury. To even consider, let alone mention, the possibility of amputation without extensive diagnostics, or at very least, an x-ray, to my mind is unethical, unprofessional and bordering on incompetency! Could have been a strain, sprain or hairline fracture. However, a 13 y/o male cat is in the risk category for myocardial disease, in which case an aortic thromboembolism is a possibility. Although most thrombi are commonly found in the rear, they can travel through the bloodstream and lodge anywhere in the body so as to obstruct or occlude a blood vessel. Based on your description of these "vets", I seriously doubt this possibility was even considered, nor was he even examined for heart disease. I’m sorry for you loss, *especially* since I believe it was an *unnecessary* loss. Cases of gross negligence and/or incompetency infuriate me. In sympathy, Phil. — "No heaven will not Heaven ever be Unless my cats are there to welcome me" –my epitaph Feline Healthcare: http://maxshouse.com
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I don’t have anything specific regarding JJ’s condition, but I wanted to say how sorry I am for your loss. He was obviously very loved & must have had a wonderful life with you.
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
I am sorry to hear about this, I hope you can get some answers that can bring you peace. Sharon
– Hide quoted text — Show quoted text -> About a week ago, I posted regarding the sudden paralysis which occurred to > my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve > damage. I brought him home on the Monday afternoon as he seemed depressed, > but by that evening he was very low so I returned to the vet Tuesday > morning. Blood tests were finally taken (from the carotid artery – never > seen that before) and although his kidney and liver functions were > acceptable, his white blood cell count and glucose levels were very high. > He was not expected to last the night. However, he was still hanging on the > next day and a urine sample showed high glucose levels, although I was told > that this could be the glucose in his blood passing through. > By now he was on a saline drip, very cold and miserable. The vet told me > that a further blood test would show if he was diabetic, but she wouldn`t do > any further tests because he was so poorly. I could not give up on J.J., as > I was convinced his condition was treatable if only we could find out what > it was. I visited every day and he developed oedema all over (I was > subsequently told he was given too much saline solution…) but sometimes he > would be quite bright, although very weak. Sometimes he would eat a little, > other times he had to be force fed. By the Friday we thought it was all > over, but I just couldn`t sign the consent form for euthanasia. We were > going to bring him home on the Saturday, but he showed definite signs of > improvement Friday evening, slight but encouraging, and the senior vet > advised us to leave him in hospital as the stress of changing his > environment might set him back again. On Monday when I visited, J.J. was > very much better, although he still wouldn`t eat. His oedema had almost > gone, his breathing was less laboured and he was able to totter around a > little and showed an interest in what was going on. I noticed on his notes > that insulin had been prescribed and assumed further tests had revealed he > had diabetes. However, when I asked the vet about this, she didn`t know. > The senior vet had instructed her to give him insulin and she assumed that > J.J. had already been given some the previous day when she wasn`t on duty. > There seems to have been a lack of consultation between both vets, and I > suggested that she talk it over with the other vet. She did seem doubtful > as to the wisdom of giving J.J. insulin as he wasn`t eating very much. > Still, it seems as if she decided to go ahead anyway, because she gave Jayge > a little insulin that evening, having thought he had eaten sufficient (how > did she know how much he had eaten? she hadn`t seen it with her own eyes > and just had the nurse`s say-so). This morning we had a call to say Jayge > had died during the night. > We still do not know what was really wrong with Jayge. All I get is a very > general diagnosis of system failure. I suggested insulin shock and the vet > didn`t totally dismiss it, but seemed unconcerned. I did not want him > opened up for a post mortem, and even if we insisted on one, it is doubtful > if it would show anything definite as I was told he didn`t seem to have any > obvious tumours, for example. His lungs were clear, his heartbeat strong > and regular. His kidneys were functioning OK. I am not accusing the > surgery of lack of care or negligence but I got the impression that there > was a certain casual acceptance that J.J. was going to die and they were > going through the motions. I shall always believe that he died of insulin > shock but if I ask why did they give it to him if they didn`t know for sure > if he was diabetic (there were no notes to suggest this), I am quite sure > that I would be told that tests had been carried out, but the results hadn`t > been written down. It is all most unsatisfactory and unsettling and I feel > very bitter. J.J. was my dearest little chap and I shall miss him > dreadfully. He was so very special – everybody loved J.J. and he loved > everybody right back > Kate > P.S. I will be changing my vet…
Response:
About a week ago, I posted regarding the sudden paralysis which occurred to my cat, J.J.`s front left paw and forearm which the vet diagnosed as nerve damage. I brought him home on the Monday afternoon as he seemed depressed, but by that evening he was very low so I returned to the vet Tuesday morning. Blood tests were finally taken (from the carotid artery – never seen that before) and although his kidney and liver functions were acceptable, his white blood cell count and glucose levels were very high. He was not expected to last the night. However, he was still hanging on the next day and a urine sample showed high glucose levels, although I was told that this could be the glucose in his blood passing through. By now he was on a saline drip, very cold and miserable. The vet told me that a further blood test would show if he was diabetic, but she wouldn`t do any further tests because he was so poorly. I could not give up on J.J., as I was convinced his condition was treatable if only we could find out what it was. I visited every day and he developed oedema all over (I was subsequently told he was given too much saline solution…) but sometimes he would be quite bright, although very weak. Sometimes he would eat a little, other times he had to be force fed. By the Friday we thought it was all over, but I just couldn`t sign the consent form for euthanasia. We were going to bring him home on the Saturday, but he showed definite signs of improvement Friday evening, slight but encouraging, and the senior vet advised us to leave him in hospital as the stress of changing his environment might set him back again. On Monday when I visited, J.J. was very much better, although he still wouldn`t eat. His oedema had almost gone, his breathing was less laboured and he was able to totter around a little and showed an interest in what was going on. I noticed on his notes that insulin had been prescribed and assumed further tests had revealed he had diabetes. However, when I asked the vet about this, she didn`t know. The senior vet had instructed her to give him insulin and she assumed that J.J. had already been given some the previous day when she wasn`t on duty. There seems to have been a lack of consultation between both vets, and I suggested that she talk it over with the other vet. She did seem doubtful as to the wisdom of giving J.J. insulin as he wasn`t eating very much. Still, it seems as if she decided to go ahead anyway, because she gave Jayge a little insulin that evening, having thought he had eaten sufficient (how did she know how much he had eaten? she hadn`t seen it with her own eyes and just had the nurse`s say-so). This morning we had a call to say Jayge had died during the night. We still do not know what was really wrong with Jayge. All I get is a very general diagnosis of system failure. I suggested insulin shock and the vet didn`t totally dismiss it, but seemed unconcerned. I did not want him opened up for a post mortem, and even if we insisted on one, it is doubtful if it would show anything definite as I was told he didn`t seem to have any obvious tumours, for example. His lungs were clear, his heartbeat strong and regular. His kidneys were functioning OK. I am not accusing the surgery of lack of care or negligence but I got the impression that there was a certain casual acceptance that J.J. was going to die and they were going through the motions. I shall always believe that he died of insulin shock but if I ask why did they give it to him if they didn`t know for sure if he was diabetic (there were no notes to suggest this), I am quite sure that I would be told that tests had been carried out, but the results hadn`t been written down. It is all most unsatisfactory and unsettling and I feel very bitter. J.J. was my dearest little chap and I shall miss him dreadfully. He was so very special – everybody loved J.J. and he loved everybody right back Kate P.S. I will be changing my vet…
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