Phantom: So far so good

About three weeks ago—October 17, to be precise—I fell and sprained (I assumed) my left wrist. The next day, Monday, I noticed not all was well with Phantom. He wasn’t eating, which for him is a great big ginormous red flag. I got him into the vet on an emergency basis, and she found that his bladder was very full but she couldn’t get any pee from him by squeezing. She figured he had a blocked urethra (which apparently is a thing with male cats—who knew), so she anesthetized him in order to catheterize him, but found a tiny crystal right at the tip of the urethra she was able to pluck off. She kept him for a few hours to see if he was then able to pee. All appeared well, so I took him home that night.

But by the next morning, it was clear that in fact not all was well, so back he went. This time she catheterized him and kept him overnight, removing the catheter Wednesday to see how he would do. I took him home Thursday, but again by the next day it was clear he wasn’t peeing, so back he went, to be catheterized over the weekend, hoping and expecting that he’d be ok Monday. But he wasn’t. I think that was the day she spelled out options for me, which amounted to: 1) put him down (since not being able to pee is ultimately fatal); 2) try another round of catheterization; or 3) take him to either Eugene or Medford for a very expensive surgery (a reconstruction of the urethra so it’s shorter and wider so pee can get through even if it contains crystals).

Phantom is a very nice, sweet cat—arguably the nicest and most social being in my household, including me—and I was absolutely not ready to have him put down. This whole thing had come as a bolt from the blue, and my brain doesn’t cope as well with crises as it once did, so I opted for a third go-round of catheterization, but decided I should prepare for the worst. By the end of the day, I had decided that even though it seems an obscene amount of money to spend on a cat, I would do the surgery if it came to that (see above about sweet cat, plus he’s only 7.5 years old and I do have the money in the bank. I would probably have made a different decision if he were 12.)

The plan was the vet would keep him catheterized until Wednesday, remove it Wednesday evening, and we’d see if he peed overnight. Both the vet and I were assuming that if he didn’t, surgery was immediately indicated. Turned out the pet hospital in Eugene wouldn’t be able to do it until the following Tuesday, but the one in Medford is a 24/7 emergency care hospital, so I got him set up with a chart there and awaited developments. I was seriously hoping not to have to make the drive to Medford and back (about three hours each way) because steering is a two-handed operation unless you have one of those knobs on your steering wheel and my wrist, while getting better, was still quite painful when asked to do much of anything.

Thursday morning the vet greeted me with “You don’t have to go yo Medford”. I happily brought him home (Shadow, who was weirded out by Phantom’s absence, had by this time settled nicely into being the only cat and was not at all happy to have him back.) Phantom clearly had his appetite back, and we enjoyed some lap time that morning.

However, by that afternoon I was beginning to be worried. Phantom was peeing, but in tiny amounts at a time. I called the vet’s office, but the vet who had been taking care of him was off that afternoon, and the other vet didn’t call me back (although I asked for her to do so.) It was two the next day—Friday—before I got a call-back, from the first vet, and she had me bring him in. The news was not good—his bladder was full and tight. She called up to Medford and was told that if I could get him there by 6:00 that evening, they could do the surgery (which now that I know more, confuses me). Since it was then three o’clock, and I learned for the first time that our vets’ office no longer can keep animals in over the weekend because of lack of personnel (the vet had done it the previous weekend out of the goodness of her heart, but she was going out of town the coming weekend), and I had it firmly fixed in my mind that not peeing is life-threatening, and I’m not at my best by late afternoon these days, and don’t drive in the dark anymore, and it’s a three hour drive and I wouldn’t even be able to leave for another hour at least—I freaked. I saw no solution, no way out.

Eventually the vet removed his urine with a syringe and I brought him home, still trying to decide if I could maybe do the drive up to Medford that night so he could at least be catheterized and not die over the weekend. However, it was raining, the road up to I-5 is a curvy mountain road, and Phantom was peeing small amounts, so I decided the sensible thing to do was wait and go first thing Saturday morning. By morning, I was more relaxed and clear-headed, and Phantom was still peeing in small amounts, so I took the time to make sure I had what I needed in the van for a couple of days if necessary, arranged with neighbors to take care of Shadow, and headed for Medford.

Altogether, Saturday was a long day, for me and for Phantom. We arrived at the SOVSC about 2:00–and began a long series of waits. Wait for his turn to come up to go in (they are on Covid procedures, so animals go in but people don’t—business is conducted in the parking lot.) Wait for him to be seen by a vet (that was a particularly long wait.) Wait for the vet to call and talk to me. Wait for him to have some diagnostic tests. Wait for the results of the tests. Wait for them to come take my money. Wait for Phantom to be checked out, and for them to bring him out. By this time it was 9:00 PM, my bedtime, and I was more than ready to be done for the night. Fortunately, they had no problem with me sleeping in their parking lot. I learned from chatting with some other people who were waiting that SOVSC is short-staffed because of Covid—some people quit because of working conditions or because they got sick, and others refused to get vaccinated once that was possible and were let go. I tried to be patient and understanding, but waiting is HARD for me, and I kept wanting more information about what was going on than I was getting. I was sure grateful for the van, which made the waiting at least more comfortable.

It was a showery afternoon, so I saw several rainbows. Finally took a picture.

What I gained in return for all that waiting, besides rainbows, was information. Information about the SOVSC process: contrary to my impression from what I had been told by my vet’s office, one cannot just show up and have one’s animal taken care of. One needs a referral from one’s vet (unless the animal is clearly an emergency case). Fortunately, I had pushed to have that happen before I left on Friday. Nor, however, will they just take one’s own vet’s recommendation for what should be done—they insist on making their own evaluation. For which one pays. I was initially annoyed by this, but in the end was glad for it.

Part of that evaluation was diagnostic tests. They offered me a urinalysis, blood tests to make sure he was healthy enough for surgery if that proved necessary, and x-rays to see if there were any stones/crystals in his bladder explaining his inability to pee. I opted for all three (they were scrupulous about informing me of costs ahead of time and getting my say-so before going ahead at any stage.) Results: a bladder infection for which an antibiotic shot he got the previous week was not effective, blood levels ok (with indications of stress—duh), and no visible detritus in the bladder. All this being so, together with the fact that Phantom was continuing to pee small quantities at a time, and his bladder was not distended and tight, the vet said they wouldn’t do the surgery, even if we hung around until Tuesday, the first possible time to get it done in any case. Apparently they usually only do it after three episodes of blockage requiring catheterization. I said, but he’s had three episodes of catheterization. But apparently not—the entire ordeal so far only counted as one episode. If he has another such episode in, say, three months, and then another in another, say, six months—then they’d do it. This was not only news to me, but it turns out it was news to my vet also she was surprised they didn’t do it, because she too assumed three distinct catheterizations were three episodes.

Once I got home, I finally read up on the surgery, which I hadn’t done before because I was too stressed to think about it. Having done so, I understand their reluctance to undertake it unless it’s unambiguously called for. Not only is the surgery itself painful for the critter, the post-operative care is difficult for both critter and owner. If I had had what I thought I wanted when I headed up on Saturday, it would have not only been very expensive, but Phantom and I would be in the midst of this difficult process even now—unless he’d died on the operating table, which does happen.

Anyway, back to Friday night. The vet didn’t see any need to catheterize him since he had peed during the time they had him. They would have kept him in overnight, but I didn’t see the point of that—I knew he’d be more comfortable out in the van, which is his home away from home and in which he’s very comfortable. She carefully offered me three medicines—an antibiotic, prazosin to lower his blood pressure and hopefully help the urethra to relax, and a pain killer. Again I went for all three, though I should have turned down the pain killer, because I won’t be using it. Knock wood. I think it was another hour, maybe more, before I finally got him back, and then had to give him meds because he had threatened to bite when they tried it. He was NOT a happy cat, and let me know that in no uncertain (for him) terms. He ate, and peed a couple small ones in the litter box, I got his pills into him (I have a device to make this possible without getting bitten), and then let him stay inside the van overnight because I didn’t have the heart to put him back in the crate and put him out for the night. Which meant I didn’t sleep as well as I otherwise would have, but I did get some sleep thanks to my gabapentin and ibuprofen PM.

The vet had emphasized that if he got blocked (as evidenced by no pee for 6-8 hours), it would be life-threatening and he would need to be catheterized. I had thought I’d stay in the area one more night, so that if that happened it would be possible for him to be catheterized, since once back home it would not be possible until Monday. But Sunday morning, it was obvious he was still not truly blocked—while each pee was small, he had peed several times during the night. I dithered while breaking camp and getting ready to drive, and finally decided to drive back to the Rogue River rest area/CG for breakfast, where I could have a nice walk with Scamp, and decide then whether to stay or head home. In the end, much as I like that CG, I just wanted to be home, so drove home, getting here about 2:00. Wiped out. I knew coming home was a bit of a risk, but Phantom had peed again while Scamp and I were walking, so I felt it was more likely to be ok than not, and so it has proved. So far.

The drives themselves, both up and back, were quite nice, though I wasn’t in the best shape to appreciate them, due to stress on the way up and being tired on the say back. But fall colors were on display, with enough blue sky between rain bouts to add to the beauty. I took this while on the walk with Scamp—the best views were while I was driving, but somehow it didn’t seem quite the thing to do to try to take pictures then what with only one fully functional arm and all, so this will have to stand in for it the rest.

I’ve been back for a week now. Monday morning, I decided maybe I should go see my doctor about the wrist. It wasn’t healing as fast as I thought it should, and the drive had definitely done it no good, so I thought just maybe I should make sure nothing was broken. Got in to see him Wednesday; he sent me for x-rays, which revealed that there is indeed a break. I have no idea what kind of break or exactly where, but have an appointment with the orthopedist up at our little hospital tomorrow, so should know more after that. Took Phantom in to the local vet on Thursday to find out if the bladder infection was gone, and to show her what he’s doing in the way of peeing (I use clumping litter, so I can save the clumps). The urinalysis revealed he’s still infected, so he’s still on an antibiotic (yet a different one), and also prazosin and gabapentin. I don’t know whether he or I hate getting those into him more. So far, he seems to be getting out a good amount of urine cumulatively, though only a small amount at any one time. Shadow seems mostly resigned to having him back, and I’m letting Phantom outside for the first time since all this started. So—So far, so good.