Pole to the vet’s (severe gastritis)

Pole did not eat on Monday’s night. I thought it was a one-off case, so I let her be.

But on Tuesday morning, she also did not eat, and subsequently, she did not eat the whole of Tuesday. By afternoon, I had contacted the vet but appointments were fully booked.

So I made an appointment for this morning.

Last Thursday, Pole vomited twice. I gave her Omeprazole and that helped and I continued with Omeprazole for 3 days just to be sure.

But last night, she vomited again (no food came out because she had not eaten). However, I did forcefeed a teaspoon of food in intervals. She had no appetite at all. I tried KD, AD as well as Recovery. She just could not eat.

I was very worried about her kidneys. Maybe it’s nausea. I was also worried that she had become hypothyroid since her TT4 readings went from 111 to 20 in just one month from Sept to Oct 2019. What if it’s gone down lower now?

So, we went for the check-up today. It was already a case of emergency since Pole had not eaten for more than 24 hours except for the one-teaspoon forcefed wet food.

The vet checked and Pole did not appear to be anaemic. However, upon palpation, Pole’s right kidney has shrunk significantly. Pole had a mild fever of 39.2 degrees. But the ear-prick blood test showed no elevation of white blood cells.

Blood was taken for a Chem 10 bloodwork. The result was not as bad as I had anticipated. Her creatinine went down from 368 last week (just 7 days ago) to 277 today, this must be due to the daily subcut of 150ml. Her urea also went down from 22.6 to 10.8 but this could be due to not eating for 1 day.  However, Pole’s TT4 (thyroid) has gone up to 67 now (normal range: 10-60), so it went from 20 in October 2019 to 67 now. The vet says it’s probably the hyperthyroidism that has caused all the problems. So we have to increase her transdermal Methimazole dose to 1.5 times.

The vet did an ultrasound to check Pole’s heart as she wanted to check if there was any fluids in the chest cavity surrounding the heart. Thankfully, there was none. The ultrasound also showed, as suspected from the palpation, that the right kidney has shrunk (is much smaller) while the left kidney’s structure is not normal. This means both kidneys are impaired now. Pole’s CKD has progressed.

The vet also suspected pancreatitis so an FPL pancreatic enzyme test was done. This turned out negative, and that was a relief.

Finally, the diagnosis of her vomiting and inappetence is gastritis. CKD can cause gastritis and Pole might already have ulcers too. So, the pain and discomfort are causing her inappetence.

To address this, the vet gave two injections. Famotidine injection for gastritis and Cerenia injection for anti-vomiting. One of them (I don’t remember which) is a very painful injection that made Pole very angry. The vet had already warned, but of course, Pole wasn’t prepared.

Pole also has medication to take:

Sucralfate tablet for 5 days: This is going to a real challenge because even the vet had problem giving this tablet to her. Finally, she had to use the pill popper several times before succeeding. I don’t know how I’m going to do it, but I’ll just have to.

Transdermal Tramadol for pain, transdermal Mirtazapine for anti-vomiting and for appetite.

Meanwhile, her transdermal Methimazole will be 1.5 times the previous dose. Recheck is in one month’s time. Hopefully, we can control the hyperthyroidism as that seems to be a main culprit in all of Pole’s medical problem.

Thank goodness three of her medicines are transdermal. I wish more pet medicine are transdermal. That would save us from getting bitten and having to take anti-tetanus jabs.

Pole will continue with the daily subcut of 150ml until she starts to eat.

The vet said she should not vomit anymore after this. If she still does and cannot recover, she would have to be on IV-drips at the clinic.

So far, Pole has expressed some interest in food, but she simply still cannot bring herself to eat. Poor Pole….

This photo was taken last night.

This was taken just now. She could not eat.

The vet says to forcefeed her 4-5 times daily, which I can definitely do, though she is not happy at being forcefed. The forcefeeding is necessary since she has severe gastritis and we don’t want it to get worse when the stomach has no food.

Pole, please get well soon.

We need to get the hyperthyroidism under control. Even the vet had not suspected that the TT4 reading would have gone up again. In fact, I thought it had gone down, and that is why I suggested that we do the test today.

Luckily it was done. It had gone up. Not alarmingly high, though, since it’s at 67. Good that we can do something to control it now.

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