Pole’s emergency – seizure or spinal spur?

Pole gave me a fright this morning.

I found her lying on her pillow, looking visibly sick. She did not come to the grille to wait for breakfast as she always does every single morning.

Something was definitely wrong.

She looked very sickly too. I could not for the life of me figure out what was wrong with her. She was perfectly alright the whole of yesterday and last night.

When I touched her, she cried out in pain.

Oh no…this is NOT good at all.

I could only think of acute kidney failure.

Or, was it due to the subcut yesterday because I did it on a different spot lower down? Or, was it due to the Methimazole (the transdermal hyperthyroid medicine) – you see, the clicker doesn’t work well, and sometimes nothing comes out, or too much comes out. I’m supposed to give 1.5 clicks each time, but yesterday, a blob came out. Was that too much and now, Pole has a case of hypothyroidism instead of being hyperthyroid?

I gave Pole her Cystaid Plus and Omeprazole mixed in tuna mousse (her super favourite) and she did not even want to lick it. So I rubbed it onto her mouth and she ate that up.

Then, I fed everyone else and offered Pole some food, but she was not interested at all. She only wanted to sleep.

Later, husband massaged her but when he touched her lower part, she started growling. There seemed to be some pain in the lower part of her body.

Pole only wanted to sleep.

I’ve never seen Pole this way before so it was very, very worrying.

Pole also could not stand up. She tried, but stretched in a very peculiar way, and slumped back into a lying down position. It appeared as she had lost her mobility.

I decided to let her sleep as it was still very early in the morning.

About one-and-a-half hours later, I offered food again. She did not want anything except AD and even that, she only licked a little bit by herself. But at least by now, she could stand.

I decided this was an emergency and I would have to take her to the vet’s even without an appointment. We would wait, if we needed to, but in case anything happened, at least we would already be at the clinic.

So, by 8.45am, we got her ready, but by this time, she was able to jump down from the pillow and try to evade us. Husband caught her and as he was carrying her out, she shot out a lot of urine. All the urine fell on the floor and I quickly took a syringe and collected some for testing later. We had not been able to test her urine each time as whenever we were at the vet’s her bladder was always too small.

So, armed with the urine sample, her food and medicine (in case she needed to be hospitalised), I drove Pole and Ginger (next story) to the vet’s. We waited outside the clinic and when the vet arrived, thankfully there were no other patients yet, so the vet was able to see us.

The vet suspects (1) a heart problem which we could rule out with a blood test, (2) that Pole had a seizure in the middle of the night which could result in her feeling so weak and lethargic when I found her this morning. Kidney patients can sometimes throw seizures due to the toxins in the blood.

I mentioned about the Methimazole dosage (the blob) but the vet did not think it could be that as Pole was not exhibiting any hypothyroidism symptoms, but we decided to still do the TT4 test today. I also mentioned about the subcut being done lower at a new spot, but the vet also said it could not be that.

Then, I mentioned about the pain in her lower part of her body. The vet touched her spine (the lumbar area) and yes, Pole yelped in pain. So, this shifted the suspicion to a spinal injury at the lumbar area and now the suspicions were (1) Pole had a seizure in the night where she could have bumped somewhere and hurt her spinal area or (2) Pole had a fall and hurt her spine, or (3) Pole has a spinal spur which can happen due to old age.

By now, the vet did not think it could be a heart problem because she checked Pole’s pulse and all was good. So she decided that the heart test is not necessary at this moment.

I also showed the vet the photos of I took of Pole and immediately the vet identified the crouching position – Pole had pain in her back.

Vets are amazing. Their patients cannot speak so they have to use whatever means necessary to diagnose what is wrong. I’ve also seen a vet make accurate diagnosis previously by looking at a photo.

An X-ray could determine if there is any injury on the spine but some injuries would not show up in an X-ray especially if the injury is small. Also, there was no point in stressing Pole out at this moment with an X-ray which would require stretching her body when there is obvious pain in that area. So the vet decided that we should manage the pain first.

If it is a minor spinal injury, sometimes by resting, it can resolve on its own.

But the most likely hypothesis is that Pole had a seizure in the middle of the night which resulted in the spinal injury. However, there was no evidence of any seizure like a pool of urine on the floor this morning. The seizure would also explain why Pole was feeling so lethargic this morning and had lost mobility in her lower half, and also the loss of control in urination this morning.

So, I am supposed to monitor Pole as closely as I can. If there is any seizure, I now have the anti-seizure medication which is a nose-drop, but I would have to scruff her and drop the medication into her nostrils, which is going to be a huge challenge. It can also be administered after a seizure.

If any seizure happens again, then Pole would have to be on anti-seizure medication for life.

For now, it is pain management with transdermal Tramadol and transdermal Mirtazapine for anti-vomiting and for appetite. The vet also prescribed Methycobal (Vit B12), once a day. It is a small tablet. Pole’s other medication will continue as usual.

A blood test was done to check Pole’ electrolytes and everything was normal. Her TT4 is still 14 which is yesterday’s reading, so Pole isn’t hypothyroid and this rules out the fact that the blob of Methimazole that I applied yesterday evening was too much. It wasn’t. Pole’s glucose level was checked – it was normal too.

With the blood test results, the closest hypothesis is still the seizure. So I would have to monitor Pole as closely as I can now. Still, it could be a spinal spur which caused pain and therefore, tiredness.

But if Pole throws a seizure and it lasts more than one minute, that would be an emergency situation and I would have to rush her to the nearest 24-hour pet hospital. Let’s hope this does not happen.

The vet also suggested that Pole be confined in a space where she could rest, maybe in a cage.

Pole’s urine was tested and the good news is there is no proteinurea and her SG is almost the same as before, just a little lower (1.014) but this is already expected since she has chronic kidney disease.  Pole was given a Methycobal injection (B12) to relax her nerves, Midazolam injection to help her relax and Fentanyl injection for pain.

Next was Ginger’s turn (next story).

So we came home.

Pole ate AD (I hid her Amlodipine in it). But later, I had to give her the B12 and four times she spat it out. And this is despite giving her a blob of AD after pilling her. She ate the AD and spat out the small B12 tablet. FOUR times. I finally managed to pill her (I hope).

The vet agreed that Pole would have to force-fed if she doesn’t eat on her own because of her gastric problem. Luckily Pole was willing to eat.

She could also jump up onto the second platform in her condo, which was good.

Pole took a long, long nap and just now, got up to urinate (all normal).

 

She has regained her mobility.

And she ate AD on her own too!

In the background, you would hear Indy trying to pick a fight with Bunny. That is what Indy does these days – he picks fights with others.

Now, he is on a warpath with Ginger. Indy is on revenge mode because he lost to Ginger that day.

Rest, Pole, rest.

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