Tuesday, November 30, 2010


The winter months are firmly upon us. I saw 2 patients last night.

Sunday was a rough day. I worked the day shift - which is from 8:30am-6pm. I didn't leave work until 10pm, unfortunately. It was a busy day, and I couldn't keep up with my medical records, thus necessitating a stay long after hours to finish them. Further, I had a patient with a case that I STILL haven't gotten a handle on. I posted about it on VIN, picked the brains of my colleagues, and have spent a few hours pouring over textbooks trying to find ANY explanation for what happened to this cat. Nothing has been fruitful. It was incredibly, incredibly frustrating, because he died about 6 hours after admission to the hospital.

His condition was extremely critical when he came in. He was in shock. His body temperature was 90 degrees (normal 99-101), his HR was 96 (normal should 180-220), his blood glucose was 40! (normal 85-300 for a sick cat), and he was as limp as a dishrag. I told the owners that it didn't look good and told them that I would be referring the cat to a specialist in the morning when he was stable enough to survive the drive. Unfortunately, I lost him. It was rather devastating.

Alas, 6 more days of work straight, then I can turn into a mental vegetable.


Holly said...

I am so sorry you lost the kitty. I will give Puzzle an xtra kiss and snuggle for you.

Outrider said...

That's too bad about the kitty.

I'd be thinking neoplasia.

C. Todd Dolen, DVM said...
This comment has been removed by the author.
The Homeless Parrot said...

Outrider: While I won't say it's impossible, the cat was 6 months old.

Todd: there were many other abnormalities along with the hypoglycemia that didn't fit xylitol (no liver value elevations, etc). The cat was persistently hyperkalemic, even in the face of fluids. He was not blocked, he did not have a uroabdomen, he wasn't Addisonian (baseline cortisol 7.7). I ruled out everything...and still had no reason for it. It was a terrible case!

Outrider said...

Wow, a young cat.

Based on age, I'd be thinking toxin or weird rare metabolic. This is one case where necropsy might have helped with closure for all involved.

The Homeless Parrot said...

Outrider: I did offer a professional outside necropsy. The owner declined and accepted my gross necropsy. I saw nothing abnormal grossly (obviously I don't assess histopath). The kidneys were beautiful, the bladder was normal, there was no urine in the abdomen...so go figure.