Monday, October 15, 2018

Harris News, Part 2 of 2

Harris waits to see the surgeon at Angell

When we arrived with Harris at Angell Memorial's emergency center on Wednesday morning, I was relieved to find someone working at the reception desk. That's not a given: twice, I've had to call the main number from the reception area to get my cat checked in and put on the emergency schedule. This time, it was smooth sailing, and there was only one case ahead of us.

In the cats-only seating area, we chose one of the long, hard wooden benches. A TV at low volume flashed across the way and a few dogs barked their heads off at a short distance. I pulled out my phone; I find Instagram comforting. My husband set up his laptop, and then he unzipped most of the top of Harris's carrier to pet him. I watched in horror as Harris's head and shoulders emerged. He looked around, wide-eyed and scared. I had a vision of him leaping from us in a panic and getting caught in the jaws of one of the big dogs that are always roaming the place, dragging their owners behind.

"Ohmygod, what are you DOING?" I said, rather loudly, in shock. I grabbed Harris with one hand, pushing him down as swiftly and gently as I could, struggling to place his splint comfortably and struggling further to close the carrier. "He could escape! What were you thinking?" I unzipped the front panel just enough for a hand to reach in to pet Harris. "Do it this way!" My husband sat wordless, miserable. This experience has taken a toll on him. I don't think even he was aware of what he had been doing.

A theatrical-looking older woman, dressed in black with a white cowboy hat, sat alone at the other end of the bench. We couldn't help overhearing the conversation when her vet arrived. Her cat was still in the treatment area. He'd been given oxygen and had perked up. She asked if she should let him die now or take him home to see how he was doing. She said she was doing a play [aha] and had to travel some distance to the theater. They decided he'd go home with her, perhaps for the last time.

At about 9 o'clock, it was our turn. A very young student vet quietly ushered us into an exam room, saying she had seen Harris's records. She listened attentively to our story. I told her we hoped to see one of the two orthopedic surgeons and that I was willing to stay all day if necessary. She said she'd try her best and left us to wait. My husband had to leave for school shortly, and we were still figuring out the best time for me to call him when she returned with a surgeon.

Have you ever met someone for the first time, looked at their face, and knew you could trust them? I looked into the surgeon's wise, candid blue eyes and knew. I didn't know if she would tell us good or terrible things about Harris, but I knew they would be true.

She examined Harris and I felt better. I liked the way she handled him. She pulled off the splint before we had a chance to wince. Harris didn't care, nor did he mind as she felt his broken toes and studied the reddened, bare patches of dermatitis on his foot and leg. She asked how he got injured and I said we had no idea. Then she sat down near him to talk to us.

I remember feeling like I was inhaling wisdom, as I often do when my own long-time vet shares her knowledge with me on topics I know next to nothing about. Everything she said sounded right to me. I didn't feel that way listening to any of the vets at the local clinic. They'd been very nice, but . . . .

She told us that cats' toes are different from other bones. She said Harris's X-ray did show more space between the broken bones, and that this was normal and a good sign. (The vet we'd been seeing told me it was bad.)  The increased separation meant that new soft tissue was forming around the breaks as the toes were healing. This tissue doesn't show up on radiographs, but the increased separation indicates that it's growing.

She told us that splints should be used only for the cat's comfort — to make walking easier. The other vet had made the splints huge and awkward, partly to help them stay on but also to make it harder for Harris to walk. It was difficult to watch him stumping around. The splint was so hard for him to maneuver that we worried about him dislocating his elbow.

No more splints, the surgeon said. Toes heal best when they are left on their own and used. (No more crate, either.) Surgery to realign the bones, which are about as slender as a toothpick, tends to damage the foot's blood supply, so it's more trouble than it's worth. And surgeons never, ever, amputate a cat's leg because of broken toes. (We were so happy to hear this.) It was likely that Harris's toes would be fine in a few weeks. Toe amputation was unlikely, too. As our own vet had said, "Cats' bones will heal as long as they are in the same room."

We were told to watch him to make sure he was putting weight on that foot. He'd probably lick his paw because of the sore patches from the dermatitis, so he'd need an Elizabethan collar for a couple of days. The young vet, who'd been listening silently the whole time, went to get us a little one, and fastened it on Harris's head. It barely came beyond his ears and seemed manageable. The surgeon told us to check in with her in a few days, and left.

I felt like a load had been lifted from my heart and brain. My husband raced off to teach (he confessed later that he dashed out before he began weeping from relief). I thanked the young vet, who said she hadn't really done anything. I told her she had done everything, and thanked her again. I picked up Harris's antibiotics and paid the bill, which was less than it usually was at the local vet.

At home, Harris limped about, looking embarrassed in his collar. The other cats welcomed him quietly, as usual, especially Possum and Toffee, who had been waiting at the door for him. Possy kept an eye on Harris as he ate a late breakfast, then helpfully assisted him in finishing it:

We could have removed the collar for meals but it seemed easier to just wipe it afterwards.

Harris stayed quiet for the rest of that day and the next. He limped and didn't use the leg. We took off the collar on Friday morning. He kept licking his paw, so we put it back. He still wanted to be brushed, and for us to rub his neck, scratch around his head, and smooth the fur under the collar. He loved all that and kept asking for more.

We noticed he was bending his bad paw and didn't mind lying on it. On Friday night, the collar came off for good. He was still subdued. I suspect he was/is plotting elaborate revenge for the indignity of the collar plus the weeks of being in a splint. We may be in trouble when he's fully back in business. We should change our passwords, hide our credit cards, and maybe cover the new leather chair in plastic . . . except Harris loves to eat plastic.

On Saturday morning, our cat suddenly came back. We first noticed him putting weight on the foot as he walked and we were ecstatic. Then he began scratching the Bergan Star Chaser Turbo Scratcher with both paws. We cheered silently as he went on to claw a low wooden chest that we aren't fond of. He romped briefly from room to room, and tried and failed to get over the pumpkin barrier I'd set up on the mantel. He leaped into my lap to lean against me, nuzzle my neck, and be praised. He was back.

Since then he's had his ups and down, using the leg and limping, having active spurts followed by long periods of lounging in his little cardboard box apartment. We must wait and see if he recovers completely, but since he can already walk without limping, we are optimistic. 

Thank you to everyone who joined us in worrying about him and wished him well!

* * * * *

I've been asking myself what I learned from this experience. What will I do differently next time? (And that means "when" not "if.")

1. I need to pay attention to my instincts about people. My first impressions tend to be sound. But I can think of many times in my life when I ran into problems because I decided to be nice and trust someone when I actually knew better. Usually these people have credentials and authority — like my first allergist, but that's another story. (Do you want to hear it?)

2. The next time we have a cat emergency and our own vet isn't around, we'll go to Angell's emergency center and do all the follow-up there, too. It's inconvenient, it can be painful to witness the heartbreaking dramas that unfold daily in the waiting area, and the student vets running the place often look like undergrads. But the level of expertise that's right behind their front line is superb, and one can ask for it and get it. It's worth it.

3. We must continue to try to be eternally vigilant: if there's any kind of hazard in our apartment, one of our cats will find it. My husband needs to keep his little office tidier. We'll probably never know what happened to Harris in there. 

4. Cat medications should always be followed by treats. Harris forgot his misery as soon as his mouth was full of chicken or turkey. He never struggled when my husband carried him into the kitchen. And the food helps move pills down the esophagus, just as a syringe of water does. (I do that, too, to be on the safe side.)

Saturday, October 13, 2018

Harris News, Part 1 of 2

This was an eventful week in the saga of Harris's Broken Toes. We dropped him off at the local vet at 7:30 on Tuesday morning for X-rays and a splint change, which meant fasting him after dinner on Monday. X-rays are painful, so they sedate him. We hoped he wouldn't come back feeling as miserable as h had the last time he got a new splint.

The vet had emergencies and didn't get to him until mid-afternoon, so I couldn't pick him up until 4:30. I felt bad for him; the vet said that the practice is about 70 percent dogs, and our cats aren't used to them. There's no separate boarding area for cats, so Harris spends hours in a room full of barky dogs. They said they'd put him in an upper cage to help him feel safer, but I doubt it helps. (When dogs come near him in the waiting room, I block his carrier with my body and tell him not to worry: they are just big bugs, and probably tasty.)

The vet was still busy. Sometime after 5, she brought him in his carrier to an exam room so we could talk. He was wearing a giant new blue splint, printed with tiny trucks. It was the biggest one so far, reminding me of a turkey drumstick. It looked very tightly wrapped at the top, near his elbow. It was so big that he couldn't maneuver in his carrier so he lay with his bad leg bent beneath him at an awkward, painful-looking angle, so I repositioned him. We'd been doing it a lot.

The vet was concerned. She looked upset. She began by telling me that he had done well and had been brave through the uncomfortable business of applying the new splint. But his foot now had moist dermatitis from being wrapped, so she'd treated the injured skin and wanted to change the splint again in just two days.

She had more bad news: his X-ray showed that his bones were not healing. They'd had trouble with their computer system that afternoon, so she could not locate his X-ray for me. But it had showed larger gaps between the fractured bones of his two toes, so things were much worse instead of better. A very serious situation.

I asked how this could have happened since his toes were protected within the splint.. She told me that she noticed that his splint had slipped a few inches when she went to remove it. She said it had slid right off when she went to remove it. She gave me a look suggesting that this was our fault. But it seemed strange; we hadn't noticed anything, and I felt pretty sure we would have. He would have ditched that splint at home if it was that easy. I'd watched him shake off a couple of other splints easily.

I wondered aloud if he had done it during the long hours he was stuck in a cage above dogs. We didn't continue to speculate because there was worse news.

She told me that the separated bones were a major concern because there is a short time window when healing should begin and, at nearly three weeks since the accident, Harris's window was either closing shortly or it might already be too late. She wanted us to take him to an orthopedic specialist at Angell immediately, and to be prepared for him/her to recommend surgery to amputate either his toes or his entire leg. I was told that tripod cats live full, active lives, which I know, but I didn't perk up. She said the broken toes were the main weight-bearing ones, so he might not be able to use his leg if they weren't functional. Then she said the surgeon might also recommend simply doing nothing until later, to see how much chronic pain he was in and how badly he was limping.

She said she'd keep hunting for the X-ray, which might be lost somewhere in the Cloud, and would send the rest of his records to Angell. Then she took my hand and wished us luck. She wanted Harris to come back in two days for a new splint if we couldn't manage to see a surgeon before then.

I brought him home. I was already late for the monthly board meeting at our local house museum, and there was another meeting right afterward. I canceled. I fed Harris, who was ravenous, and gave him pain medication. My husband arrived and I gave him the news, and got on the phone to Angell. I asked for an appointment with one of their top two orthopedic surgeons. I was told they were scheduling in mid November, so I said we had an emergency, knowing we'd be getting in line in the ER and paying a higher fee to see a specialist quickly. The liaison said the surgeons had left for the evening but they'd both be in at 8 am. She recommended that we arrive then and prepare to wait. I asked if we should fast Harris in case he needed surgery and she said yes.

An hour or so later, the vet found Harris's X-ray and sent it to Angell. Then Angell called to tell me they were all set to see us in the morning.

Harris spent the evening lying under the armchair, where he now tries to hide when he's in pain. He lays very still with his eyes open. He has an expressive face, at least to us. We think we can read him very well. We think he's miserable when he's lying like that.

We felt miserable, too. I'd been mildly sick to my stomach since I heard the vet say "amputate" and the idea of a three-legged Harris seemed terrible and wrong, since only two little toe bones were broken and he had an entire, healthy, handsome leg above them. I felt sad, scared, and awful and my husband was in worse shape.

Our plan was to take him to Angell by 8, and I'd stay all day if the surgeons were busy. My husband would have to leave around 9:30 to teach a class. I canceled my Wednesday appointments and fed Harris a second supper because he'd be missing breakfast. His leg has never affected his appetite.

I wrote to our long-time vet, asking for advice. She'd kept in touch once or twice a week since the accident, mostly with reassurances: she didn't think crating was necessary if Harris kept his splint on. She also said that cat bones will heal "as long as they're in the same room," so even splinting wasn't essential. However, she hadn't examined him and she wasn't his vet at the moment. I wondered what she'd tell us now. If only her new clinic was built and open for business.

After Harris's accident, a friend who is a cat expert advised me to keep him crated and sedated for the several weeks it would take him to heal. She told me to board him at the vet for that time, since we couldn't stand seeing him caged and miserable. Sometimes "tough love" was necessary, she said, and a few bad weeks would be forgotten. This felt all wrong to me; I disagreed. Trauma can alter a cat's personality, and weeks of crating (especially near dogs) and isolation could be traumatic for Harris. I couldn't imagine him lying sedated in a cage for weeks and weeks. I was afraid he'd come home as a less trusting, confident, optimistic cat. Then we'd have to reintroduce him to the other cats, which would mean isolating him in our small office for more time. I couldn't get on board with any of this.

When I told my friend the latest developments, she told me again that crating and boarding were the only things to do. Letting him roam around the apartment had been a mistake and he would now pay the price. I reminded her that our long-time vet had thought it was fine. She disagreed with so much authority that I began to doubt my instincts. Would Harris lose toes or a leg because we were wimps who valued his (and our) immediate comfort over his long-term health?

It was probably too late to change course now. We'd soon hear what the surgeon had to say.

We didn't get much sleep that night.

The next morning I filled my knapsack with a phone charger, September New Yorkers, a sandwich, snacks, water, canned cat food, and a shawl (Angell is chilly). We gently put Harris and his huge blue splint into his carrier. He didn't struggle. He is the sweetest cat.

My husband was rather emotional; he has a hard time when a cat isn't doing well and limping animals break his heart. If we see a dog with paralyzed legs rolling along in one of those devices with wheels, it guts him. (I'm made of slightly tougher stuff.) We made the 20-minute drive to Angell wondering if we'd be coming home later in the week with a three-legged cat.


Spoiler: We came home with a four-legged cat. I hope you weren't eager for a cliff-hanging drama. I don't like leaving readers in suspense over anything serious. Don't we have enough stress in our lives these days? We were wrecks and now we are not, so stay tuned to hear what happened.

Sunday, October 7, 2018

Another Harris Update

Harris seems to be feeling better despite being encumbered with a splint. That means the stress level around here is lower for everyone. This morning he napped in the sun and rolled upside purring as I spoke to him, just like he used to before this mess began. He also demanded rides in his box. He settles in and we have to drag it all around the bedroom rug in ovals and figure-eights and spin him around. He gets wide-eyed and as giddy as a cat in a box can get; he loves it and can't have enough.

We stopped giving him opioid pain medication because the vet said two weeks was long enough. Now he is just getting a low dose of gabapentin twice a day, which is what our long-time vet also recommends for her patients in splints. It has painkilling and calming, anti-anxiety effects. Harris doesn't seem much altered by it. He is quieter and seems calmer but he is alert and still wants his own way all the time.

He isn't jumping as much as he'd like, however. He's able to jump up and down from tables and windowsills and other low spots, although we help him if we catch him in the act. He rarely tries any risky, high jumping. This is partly because I've made it impossible. There's a sofa pillow on his favorite high bookcase, hanging over the front so we have to tilt our heads to we pass it. He also liked to sleep on a tall covered basket we kept on top of a wooden chest, so I put the basket is on the floor and now he's not interested.

And I turned the mantel into an obstacle course:

This should be cat heaven for sending pumpkins and gourds to the floor, but only Harris and Toffee like to do that, and neither has tried to get past that blue pumpkin, which I picked in a field yesterday in New Hampshire.

We stopped policing Harris all the time. It was exhausting and we were bad at it. It convinced us that we were right not to have children; any toddler of ours would run into the street fifty times a week.

We stopped putting him in his crate after we saw how much he hated it. He injured his nose and a toe on his healthy front paw escaping from it, which he can do whenever he pleases, so it was pointless anyhow.

We could still screw this up somehow, but I think we can handle a few more weeks. He is going to the vet on Tuesday for sedation and X-rays, and then a new splint. I'm dreading it because he was so miserable after his last appointment, which was only a splint change. But it needs to be done, and I will tell them to make the splint more manageable for limping. The current splint seems to make walking more difficult than the previous one. The vet told me they do this by design to make all movements harder for the cat. I wasn't consulted. Harris will do as he pleases no matter how much trouble his splint causes him, so anything else is just not fair to him. He has enough problems. Don't we all?

Thursday, October 4, 2018

Harris and Possum

Harris was better today, and we are grateful. My husband was home all day, so we let Harris out of the crate to roam where he pleased, although we made sure he didn't jump from any high spots. He seemed less uncomfortable — no restlessness or hiding — although he spent time licking his splint. If he bit it or kicked at it, we'd assume it was the problem and have it removed, but he leaves it alone most of the time. And he took off three splints by himself without any trouble, so he can probably do it again if he wants.

Possum has also been taking care of Harris:

Possum was excited about Harris from his first glimpse of him six years ago. I remember how Possum was lounging on the sofa when we brought Harris's carrier past him through the living room and into my husband's office, where we planned to keep him separate from Wendy and Possum for a week. We figured there'd be hissing, growling, perhaps swatting, from one or both of them. Instead, Possum perked up and gave us what I can only describe as an approving, "What took you so long?" look. And Harris seemed happy about everything: us, his new little room, and Possum's paw appearing under the closed door.

Harris spent only a few days in the office, but paws kept meeting underneath the door, and toys went back and forth. Harris became Possum's beloved little brother on Day 1 and it never changed.

We see a lot of these affectionate scenes but I ran for my camera when I saw the Possum had his paws around Harris's neck:

Harris didn't mind.

Possum knows something is wrong with Harris and is clearly concerned about it. Harris goes to him for comfort and Possum provides it, washing him and cuddling close.

Harris adores Possum's attentions:

The other cats are polite towards Harris, and we've seen Toffee and Lion both briefly washing his head. No one troubles him, or tries to steal from his bowl, although he can steal from theirs. That's love.

Wednesday, October 3, 2018

Harris Update

Harris was doing well yesterday morning. He was moving around more easily with his splint and seemed more like himself as he limped around, sunned himself in the window, and enjoyed getting attention, snacks, and "brushies." I had given him a little less pain medication at breakfast and thought we had turned a corner. It was nice to follow him around while he was having a good time for a change. He even nuzzled my neck and purred in my arms like in the good old days (of two weeks ago).

He was due for a splint change in the afternoon, and went politely into his carrier for the walk to the vet. When we got there, dogs were roaming the waiting room off-leash, so I covered his carrier with my raincoat and sent psychic rays toward the dogs to keep them away.

Harris plots revenge as we wait at the vet

He was returned to me with a new splint and seemed subdued. At home, he was restless and seemed uncomfortable, lying in awkward positions with his eyes open, never napping. I gave him more pain meds. He hid, which he never does unless he's in pain. He hung out with Possum, who loves him.

I called him, he came out, and I zipped him into his crate. He hated that, so I let him out — he's going to destroy the mesh door soon if he continues to work on it. I fed everyone supper and then I had to put him back in his crate because I had to go out for a few hours. He protested.

When I got home, he wanted to be let out, and I obeyed. He found Possum and buried his head against him, and Possum licked his head and comforted him. He curled up between Possum and Toffee on the bed and rested, eyes open.

He continued to be restless and unhappy through the evening although we gave him extra pain meds. He doesn't seem much better today, although it's hard to tell because we gave him extra medication again this morning and it makes him zombie-like. He eats and likes being brushed but he's just . . . not himself.

I just have that feeling something isn't right.

He won't put weight on this splint as he did with the other one.

My husband spoke with the vet, who said she was very careful applying the splint and so it shouldn't be bothering him. If it were, he would be licking and biting at it, and trying to remove it, and he's not. That makes sense. She thinks he is just stressed from the vet visit, but that doesn't make sense. Not the hiding and the lying about with his eyes open.

I'm not sure what's going on. I'll give him tonight and tomorrow morning to improve. If he doesn't, then it's back to the vet for either Splint #6 or just a removal. I don't feel good about either choice but he can't continue like this. We were hoping we could keep him in a splint for at least two or three weeks to give his toes a good chance to heal properly, but it may be too much to ask of him.

He is sleeping near me on the bed as I write this and I hope he's feeling better.