More Fun at the Vet's

Today’s vet report: I took Peanut to the vet at 10:30 this morning to see why his pupils are constantly hugely dilated, no matter how bright the ambient light is. Since his bloodwork needed to be fasting he got imprisoned in the half bath while the others gobbled breakfast, which pissed him off. Mr. Grumpy got released; discovered NO BREAKFAST! and stalked about muttering; hissed when I picked him up and swore mightily when I stuffed him in the carrier.

His mood at the vet’s went downhill from there. The vet and her assistant had a hard time of it, even with a burrito-forming towel, even with cat-handling defensive gloves up to the elbows. No one got hurt, blood got extracted, and his indignant eyes got examined despite his furious physical and vocal protests. The vet had wanted to check his blood pressure, but given how worked up he was it would have been futile to even try.

So what was determined in all the sturm und drang? The vet believes there’s a partial detachment of the retina in one eye, though both pupils did react somewhat to light during her exam. We need the bloodwork to confirm it but she believes he’s likely hyperthyroid; among its other effects, it raises blood pressure, which stresses blood vessels, including the tiny ones between the retina and the back of the eye, causing leaks that put pressure on the retina and can detach it.

So now what? Well, Pumpkin’s T-4 test results have come in, and yup, he’s hyperthyroid, so we’re going ahead with the methimazole gel; my local pharmacy can compound it for me and it should be available Monday or Tuesday. I’ll start using it on Peanut too while we wait for confirmation.

Hopefully treatment will reduce Peanut’s aggressive moods as well. Come to think of it, Pumpkin’s been crabby towards his brother Squash since he started losing weight, so maybe it will help him on that, too. The vet also told me about a dry food Royal Canin makes, a formula that’s supposed to help calm down stressed-out cats, yet is safe for all cats to eat. She’s going to try to get me a sample bag to see if it will help Peanut.

The vet still wants to see Peanut again, try to get a better look into his eyes than she was able to this time, which will likely require some sedation. I’m not looking forward to it.

Here’s a photo from back in July that shows Peanut’s pupils as they were then – already somewhat dilated. At this point they’re even bigger, only a thin ring of iris visible around the black of the pupil.

Poor Pumpkin

Pumpkin endured another trip to the vet yesterday, to see why he continues to lose weight. His appetite is somewhat erratic but he does come faithfully to every meal and eats his wet food, or at least a modestly decent amount of it; he's gone right off dry food. His behavior is normal but he vomits a little yellowish fluid pretty much every day. So the poor little guy got stuffed into the carrier despite his struggles and protests and delivered into the cruel veterinary hands.

Vet: Pumpkin! He's such a handsome little guy, I love him so much!

Pumpkin: You're gonna rend me limb from limb and eat me!!!!

They took samples of blood and urine, checked his vitals, and so forth, and then Dr. Corbett and I discussed possible diagnoses of the skin-and-bones Pumpkin, who's shed a pound plus since his last exam and is now under eight pounds (when he was fat he weighed in at 18 pounds). We had a further discussion by phone this morning after initial blood work results were in. Conclusion:

We don't know!

The trouble is, his symptoms and test results conflict. Symptoms of weight loss but normal energy: look like thyroid. Test results: Not so fast; the thyroid value is in the gray zone, not clearly off; one white cell count is slightly elevated, suggesting something inflammatory; with the weight loss and erratic appetite that looks like inflammatory bowel disease -- but he's not having diarrhea, just normal BMs. He does has a new finding since his last exam -- a heart murmur.

So now what?

It could still be thyroid. Dr. Corbett's going to send a blood sample for a T-4 test, which might show it -- but Punk's previous T-4 in May was normal. If it's abnormal now we'll start thyroid medication. There are pills, liquid, and special foods, but knowing Pumpkin, the pills or the liquid are most likely no go. I brought a can of the special food home to try and he rejected it. That leaves another possibility --transdermal methimazole, a gel you rub on the back of the cat's ear twice a day.

Or maybe the T-4 is still normal. Then what? Despite the lack of diarrhea it could still be intestinal inflammation, and one treatment would be steroids -- but the heart murmur makes that dauntingly risky.

Dr. Corbett is frustrated! She so very much wants to help the little golden guy. She's planning to do research over the weekend to see if she can figure out exactly what's going on and what if anything we can do about it -- keeping always in mind we're dealing with a 15-year-old feline with a heart murmur here, who shouldn't be put under anesthesia. At least his teeth are reasonably good, not much tartar and not much gingivitis; surprisingly good, in fact, for an old guy like him.

It All Adds Up

How much proofreading of transcripts do I do? How much have I done over my career?

I started doing this full-time in 1987. Page totals vary quite a bit from day to day, week to week, but 400 to 500 pages per day isn't uncommon, more is not unusual (998 in one day is my peak in the last decade) and I normally work at least six days a week, pretty much every week all year. And I've been doing this for call it 29 years.

So figure, say, 2000 pages a week to be conservative, 52 weeks a year -- that would be 104,000 pages per year. Rough estimate total for 29 years?

3,016,000.

I wish I hadn't figured this out.