We have been having some cat and human medical drama, nothing with a Terrible Ending as of yet, nothing with Covid involvement; the title is a spoiler but I will tell the stories.
The week before last, Paul took Henry on The City Trip, where Paul and kids/kid take a train to a far-enough-to-be-fun city and do fun tourist things for a week, and they follow Paul’s vacation preference that they not eat anywhere they have the option to eat at home (I am more the “eat at Taco Bell because I am already at my limit for newness” type of traveler, though I WILL eat adventurously AND enjoy it IF someone else handles the arrangements, and Paul is good at handling the arrangements). He took Rob and William on this trip when they were in the 11-13 age range, and then took the twins when they were about that age, and then Henry’s trip was planned for summer 2020 and so you will not be surprised to hear it was canceled. And last summer didn’t feel safe, either. And this summer didn’t feel safe EITHER, but there apparently comes a time. So they went, bringing masks and Covid tests, and they had a great time.
On Friday morning at their hotel (not yesterday-Friday but a week before that), right before they were due to catch the train to head home, Paul started having what he thought was probably kidney-stone pain. He managed to get himself and Henry to the train THANK GOODNESS (the first text he sent me wasn’t clear on that, and my reaction was GET TO THE TRAIN, GET TO THE TRAIN, FOR THE LOVE OF GOD GET TO THE TRAIN AND THEN WE WILL FIGURE EVERYTHING ELSE OUT); and William and I drove together down to the train station, and then William turned around and drove my car back, and I drove Paul’s car (including Paul and Henry) back, because Paul was in too much pain to drive. Since then Paul has not been able to go to work, and has been doing a lot of groaning and writhing and pacing. But he’s had kidney stones before, and they have passed without medical intervention, so he felt he could cope. (I was not sure I could cope.)
Meanwhile one of our cats has been losing weight again over the last few months, and also started sometimes peeing outside the litter box. He went to a substitute vet (our usual beloved vet wasn’t available for a sick visit that day) who prescribed antibiotics in case this was an easily-treated UTI; and then a week and a half later we saw our usual beloved vet for his annual exam (I didn’t trust the substitute vet and was glad we already had the annual exam scheduled) and she suggested an ultrasound and a more intensive pee analysis, which was scheduled for this past Wednesday.
That same Wednesday, Paul had a doctor appointment scheduled because the kidney-stone pain was continuing and it seemed like time to consult someone, but we ended up canceling that appointment because he went to the ER instead. William had to drive him, because I was dealing with the cat’s appointment and also Elizabeth’s annual pediatrician check-up. If Paul had been willing to wait an hour, I could have driven him; but it had gotten to a point where he did not want to wait an hour.
So we had Paul at the ER, and the cat at the cat hospital, and I didn’t know when either of them would need to be picked up. “At the exact same time,” is of course how it turned out.
By then Paul was on an IV of painkillers/anti-nauseants and sending perky gossipy updates from the ER (“They’re boutta put a woman in restraints, I think.” “Oop, there she go!”). When he first arrived, they’d told him they were completely full so they would try to find an EMT to check him out, but then I think his pacing/groaning got him bumped up the list, so they put in an IV and put him on a gurney in the hallway along with several other patients they didn’t have room for. He did get a CT scan (I was worried they would send him home with painkiller and a referral and no scan), and they said the stones are 8mm, and they said 4mm is generally the largest a person can handle without medical assistance. They gave him a prescription for painkillers, a prescription to relax various tubes/muscles, and a referral to a urologist.
Meanwhile the vet called me with the cat’s results. She said this second ultrasound (he had one two years ago) confirms that he has one kidney that has basically shut down and another that is compensating, which is a perfectly sustainable situation for a cat or a human as long as nothing else happens. The bad news is that something else has happened: he had a bunch of kidney stones and they were piled up in his urethra. (There is another large stone lodged in the kidney that has shut down; she thinks that might be WHY it shut down.) She further made it clear to me in her tactful way that the two choices were surgery or putting him down: this was a situation that would lead to A Bad Crisis at some point likely very soon; she described him as “a ticking time bomb.” She said she was going to try to rearrange her schedule the next day so that she could do the surgery then, because she didn’t want him to have to wait until next week; she did manage to do that.
It is tricky math to figure out how much money is worth it to save a pet—similar to figuring out which repair is the one where you sell the car, but more fraught. In this case I came down on the side of paying for it: he’s only middle-aged, he is a beloved cat, the cost is Within a Certain Range, etc. This is the kind of expense where Paul soothes me by saying “This is WHY we EARN money: to PAY for things.”
The cat, like Paul, was given a painkiller and a medication to relax various tubes/muscles. Both of them were stoned out of their gourds. The cat kept leaping up on things and MISSING, and walking along the edge of the counter with one paw slipping off the side, and falling into the sink. Paul kept singing operatic snippets of songs, and starting stories he couldn’t remember the endings for, and wanting to talk about WHY he might be feeling so much better, and misplacing his phone.
On Thursday morning, the cat had surgery. They first put in a catheter and used it to push the stones back into his bladder, and then did an incision and removed the stones from his bladder. He is recovering well. He is still telling us he loves us and asking us if we have ever really looked at our paws. He has what the vet calls “a very bad haircut” (shaved sides for the ultrasound, shaved belly for the incision, shaved wrist for the IV, and a shaved area at the base of his tail for the equivalent of an epidural). He has an Elizabethan collar he is supposed to wear whenever we can’t keep an eye on him. He has various prescriptions.
On Friday morning, two days after he went to the ER, Paul went to the specialist, who ordered more bloodwork (he already had bloodwork in the ER) and x-rays (he had a CT scan in the ER). That was Friday morning before a long weekend. The specialist did not call Friday afternoon as we’d hoped. Now it is Saturday, and we still have Sunday and Monday to get through, so if you have kidney-pain-reduction suggestions, Paul would LOVE to hear them. He has ketorolac and tramadol for pain, both of which he had to PRESSURE the doctors to give him (both the ER doctor and the specialist were going to give him NOTHING for pain), and he says the ketorolac works better but they won’t let him take it longer than 5 days and tomorrow is Day 5, and anyway it consistently wears off about an hour and a half before he can take the next dose; the tramadol doesn’t work as well as the ketorolac, also wears off early, AND makes him feel crummy; he’s also on flomax. (The cat is on gabapentin and prazosin.)
I missed the whole Cat AND PAUL have stones connection. Mygawd. I hope you’re having a bit of something-something to soothe.
I know i just messaged you but omg did I laugh at “He is recovering well. He is still telling us he loves us and asking us if we have ever really looked at our paws.” and High Paul texting E.R. updates is my new jam.
Lots of water or fruit juice is recommended but that causes using the bathroom so I can see where that’s not fun. Breathing exercises, maybe? :)
Someone in this house who has a prostrate uses Saw Palmetto. I wonder if that would help?
Holding space for you and sending love. I’ve never had kidney stones but OMG, I can’t believe the doctor is leaving Paul hanging like that over a holiday weekend.
And your description of the two of them high as kites has given me life.
Yes, the holiday weekend makes it so much worse! If Paul needs to go back to the ER, best do it before tomorrow night when all the chuckleheads will be in there with fireworks injuries.
This is about to be a super vague and possibly unhelpful comment, but if he’s on anything not stone-related, I would look into whether it could be reducing the effects of the pain meds. My cousin was on a narcotic that was doing nothing, and we discovered via research that that particular med is rendered way less effective if you’re also on an SSRI. (Apparently it was a recent study, not known by the specialist she was seeing. The results of the study were calling into question what would ordinarily be considered drug-seeking behaviour. It was interesting to read about.)
I hope Paul gets some relief soon. And I’m glad the cat is okay.
That is very interesting. Do you happen to have a link to that study, or other further information? I’m on an SSRI, as are some friends of mine, and that’s the kind of information that can potentially prevent someone having a really really bad time.
I would like to commiserate on the pet injury/illness issue. It’s awful, but in this case I agree with you. Out of curiosity, did the vet say it’s an issue likely to recur? Because that’s what the urologist told me. I did not lead with my own kidney stone solutions because I don’t really have any. TMI warning! I had virtually no pain when I had a kidney stone, until I started peeing what looked like straight blood. That was a trip to the ER and a cat scan. I eventually saw a physician assistant in the urologist office, who was clearly Not Good at her job*, but she said I would pass it, and my symptoms resolved and I haven’t had a problem since. BUT, she did say that I would have less issues in the future if I drank a ton of lemon water every day. (*I asked the PA about my unusual-but-not-rare kidney issue, horseshoe kidney, where the kidneys are fused together. And she asked me, oh, which one is horseshoe? Not going back to that person!)
The vet is sending the stones away for analysis, and says that analysis should give us a better idea if this is something that’s likely to keep happening no matter what, or if it’s something we can prevent. The former would be…difficult to justify, pet-expense-wise, so I am REALLY HOPING for the latter.
Holy crap I’m so sorry, gosh.
When I have particularly bad dental pain, I read once that icing between the thumb and forefinger of the hand on the relevant side can help. That actually does help a bit! For me, it’s not so much that it actually takes away the pain, it’s more that having another strong sensation is a small distraction.
So I do wonder if Paul icing another area of his body might be useful. It shouldn’t hurt him worse, at least.
Similarly, a couple months ago I bought a little wooden whirly thing with rollers for under my work desk, where I can push down and back and forth with bare feet. That has helped the circulation and therefore pain in my feet quite a lot.
I am not saying that Paul has circulation issues, but I wonder if reflexology stuff might help him. It sounds a bit airy fairy to me, but I have read that quite a few studies have shown it can help – and again I doubt it can make him feel worse to just rub a part of his hands and feet.
https://www.binomassage.com/blog/seven-important-pressure-points-on-your-hands/
https://www.watsons.com.sg/blog/health-wellbeing/diy-foot-reflexology-sleep-better/
Also, as I’m sure you’re aware, it might just be helpful for him to have SOMETHING to try even if it doesn’t really help. Good luck!!
Your descriptions of Paul and the cat on their meds made me laugh. Unfortunately I think the strong stuff is the only way to touch the pain for kidney stones. I had a morphine drip when I was hospitalized for having a stone while pregnant. The stone passed and I went home the next day. I was worried about the pain med and the baby and used the drip (could press a button) lightly. It was great to get some instant relief when the pain came on. The comparisons for childbirth between passing a stone are dead on.
I had a kidney infection (not stone-related) while pregnant and it was BY FAR the worst pain I’ve ever experienced. Far worse than childbirth. Worse even than an abscessed tooth, which is the second worst. I was worried about my baby but welcomed the painkillers with open veins.
Paul and the cat have my deepest sympathy. I had kidney stones once. I like to think that I have a high pain tolerance; that’s what doctors tell me, but who really knows. It was the worst pain in my life. I remember proposing to the nice nurse who put the pain drug in my IV. It was a little awkward with my husband in the room, but that man was my new best friend. I ended up having to have the laser surgery where they blow them up? I think? I don’t have a clear memory of the decision-making process. Fortunately, my doctor hooked me up with pain meds, and I spent the next couple of days of wait time in a woozy, highly drugged, and pain-free state. The post-surgery stint was not my favorite, but it was highly preferable to that pain.
I too am enjoying the tales of whacked-out residents.
My own guideline for “how much to spend on a beloved pet” is to figure out if there is anything I could spend that amount of money on that would make me happier. And that is why the best dog ever got some very expensive attention and I have no regrets.
This is an excellent strategy.
My little cat had kidney issues and the best rated kidney food that wasn’t a prescription was Wellness morsels, if you want to try adding that into the mix. Tiki was partial to poultry, but they had fish flavors also. And the morsels are soft enough to mush into a pate-like texture if needed.
Wow, what an ordeal. I like Paul’s “this is why we earn money, to pay for things” mantra. It’s a good one to think about.
Very entertaining!! Can’t wait to hear the end of the Paul Story. You make me laugh out loud!
I have no kidney stone advice to offer, I’m just coming here to say I’m thinking about you and hooping things get substantially less dramatic/stressful soon!
I am sorry for Paul and the cat, and for their caretakers. The paragraphs about them being high made me giggle – I love your ability to see the humor in dark situations! And poor Paul, having to wait the entire long weekend! That’s not cool!
What are the odds that both Paul AND the cat would both have kidney stones at the same time??! Not having ever had them; I have no advice for either Paul or the cat.
But the bit about them being high was hilarious.
The fact that the cat got better, more attentive care by the medical establishment is…disappointing but perhaps not surprising?
My husband had an 11cm stone. He hung on until the urology consult. They were ready to set him up for lithotripsy when they went down his med list. Because he was taking a multivitamin with vitamin E as well a baby aspirin, he had to be off of those for 5 days so they could clear his system. They have a blood thinner action and make the procedure dangerous. Something to consider if he’s taking anything like this. The urologist gave him pain meds for the interim but they wore off with an hour to go before the next dose. He got a little comfort from a heating pad but YMMV. It’s such a hard experience. He’ll need a driver for the procedure and afterwards he’ll feel very beat up. Also expect some bleeding when the stone remnants pass. They can be sharp edged.
Centimeter?!?! Or millimeter? I am boggling if it’s the former!
And I am having flashbacks to the way our childbirth prep class instructor pronounced it “SONTimeters”
Haaa you’re right! I meant mm, not cm.
Doing a Tuesday check in. I hope Paul is getting relief and that you are holding up okay. XOXOXO
Wow, what a crazy coincidence. I’m a few days late here, so I hope they’re both feeling better.
Checking in on everyone and thinking of the Thistle Family – people and pets.
Thinking about you and Paul and the cat, and hoping all is as well as can be expected.