Cow Mau’s 2nd laser treatment

We’ll start with the second morning breakfast. I wanted to make sure Cow Mau won’t be hungry before we went for his 2nd laser treatment today.

About an hour after this second breakfast, we made our way to the clinic.

There was another emergency, so we had to wait a bit.

Then, it was our turn.

Blood was taken to check the necessary parameters. Then the laser treatment was done. I’m making all the laser therapy photos black-and-white so that you can at least see something. If in colour, all you would see is a flash of bright red and everything is red.

Cow Mau was so relaxed throughout the laser therapy and even allowed the vet to open his mouth and do the inside of his mouth.

Soon, we got the blood test results.

First, the good news. We were very worried that Cow could be anaemic because he looks pale. But the blood test shows that his HCT (hematocrit, aka PCV) is 29.9% which is unexpectedly good! Even when drawing the blood, the vet already said it looked “good”. So, that’s one hurdle crossed! The paleness is due to his failing heart.

Now, the worrying news are:

  1. His WBC (white blood count) is off the roof. Incredibly high. This means Cow Mau is fighting off an infection. He has to start on antibiotics immediately, which is Azithromycin.
  2. His urea is also off the roof at 30.7 but his creatinine at 193 is still within a reasonably safe range. SDMA is 18. The vet says a urea reading this high can cause internal haemorrhage. So he needs to be on Azodyl and Renal-Combi (phosphate also found to be high, at 2.48).
  3. Cow Mau has very bad mouth ulcers on the gums where his upper canines are located on both sides of the mouth. To address this, the vet prescribed Oral Aid 2-3 times a day.

Based on the off-the-roof urea reading and reasonable creatinine, it shows AKI (acute kidney injury) which, thankfully, can be treated. This could be due to inflammation or the Furosemide which had to be given earlier on because of the fluids which surrounded his heart and lungs that made his breathing so laboured three days ago.

The nasty mouth ulcers are at his upper canines, so I guess this is why he finds it so hard to pick up food with his mouth. Yesterday, I noticed Cow Mau placing his mouth above the surface of a water bowl, then he moved away and did the same on another water bowl. He just couldn’t even drink by himself. So I quickly syringed water into his mouth. Cow Mau has a very high pain threshold, so if he cannot eat and drink, those nasty dreadful mouth ulcers must be really, really bad. I’m glad we discovered exactly where they are now and we can treat them.

Another piece of good news is that Cow Mau does not need oxygen anymore (and he himself knows it because he moves away when I turn the machine on). The vet listened to his heart and lungs and all sounds good now. So, no ultrasound was needed. Cow Mau also breathes without opening his mouth and his nostrils are not flared.

When we brought him on Monday, he was actually in very dire straits. His breathing was so very laboured so we had to do everything to help him breathe better. Now, he’s breathing normally already with an SRR of 24 (completely normal). The vet is actually really happy about this and so are we!

And another piece of good news is that although the pinch test shows Cow Mau is dehydrated, the vet checked other signs (like his eyes and mucous membranes in his mouth, for example) and says he isn’t as terribly dehydrated as I thought he was. Whatever it is, Cow Mau cannot have subcut fluids. We absolutely cannot risk him getting the fluid accumulation again. That’s just way too dangerous.

So we have three concerns today:

  1. Azithromycin for the infection Cow Mau is fighting off.
  2. Oral Aid for the really bad mouth ulcers.
  3. Azodyl and Renal-Combi to lower the urea and phosphate. The urea is the more concerning issue compared with the phosphate. The vet says if the supplements work, the urea should come down in about 4 days.

Now when I compare notes with Indy’s sudden CKD discovered in September last year, his urea reading was even higher than Cow Mau’s now. And yet, our Spider-Cat is, well….Indy will always be Indy. Nobody can quite figure him out!

There was another concern also, and that’s about Cow Mau being very sleepy all the time. This could be due to the Gabapentin and Tramadol, so as a first step this week, we are reducing the dosage of Tramadol.

This Japanese liquid diet is really good, so I bought up whatever the clinic has left but I did ask if any other client might need it too and the vet says so far, no one. The good thing about it is that it’s a powder so I can mix the amount I need and nothing is wasted. Cow Mau also likes it. The vet says she will be ordering new stock.

The clinic has another kidney liquid diet but the vet says it’s better to just stick with this Japanese food and the raw minced chicken and Cubgrub since Cow Mau is okay on these.

On the way back, Cow Mau was SO comfortable. He didn’t even need me to carry him anymore. He sat by himself in his tray.

We’re home now!

The vet was amazed at Cow Mau’s stoicism. I am, too. But I’ve always known Cow Mau to be incredibly resilient and stoic. And his pain threshold is incredibly high as well. But the vet did say that often, our pets rise to the occasion because of us, their parents.

Cow Mau keeps wanting to go out to Ginger’s Catio, but to play it safe (as the Monsters can be unpredictable), I took him back to Bunny’s Place to get some sunshine.

Cow Mau now stays with me in the Safehouse because he wants to stay near me. If he is inside Bunny’s Place, he will call for me.

We came home and I quickly plonked in the Azodyl because it is to be taken on an empty stomach. Then we had lunch and it was very much easier to feed Cow Mau now, right after the laser treatment. It was the same after the first treatment too.

I did ask the vet when she did today’s laser treatment if the inflammation inside the mouth had healed even a little bit. She says it hasn’t. So some infection is going on causing all this inflammation and hopefully, the antibiotics will address this and bring down the inflammation and with it, the pain too.

Strangely, Cow Mau was already on Convenia for the past two weeks, but looks like it wasn’t strong enough to address this infection.

But it’s time to look forward now, or at least, live in the present moment and do the needful.

Giving Cow Mau water by syringe again.


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