Sugar&#8217;s not fading away, yet
<p>Judging by comments, a surprisingly large number of my regulars are interested in the medical state of my house&#8217;s <a href="http://www.beliefnet.com/Love-Family/Pets/2009/08/Cat-Quotes.aspx?p=2">visible soul.</a> If you&#8217;re not of them, go ahead and skip this blog entry.</p>
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<p>It&#8217;s now three weeks and change since the crisis that nearly killed Sugar.  And it is less clear now than we thought it was two weeks ago what actually happened to her.  The diagnosis after the sonogram was a serious kidney infection.  After antibiotics and 72 hours of hydration she <a href="http://esr.ibiblio.org/?p=3708">bounced back amazingly</a>, displaying more physical energy than we&#8217;d seen in years. Like, casual three foot jumps to get from chair to daybed.</p>
<p>But the culture from Sugar&#8217;s urine came up negative. That is, no evidence of bacterial infection.  So either we&#8217;ve had a lab error or something else was going on.  Our vets (Drs. Hayduke and Rockwood practice as a team) are puzzled.  Dr. Hayduke says he has no explanation.  And the really interesting question is whether it was mostly the antibiotics or mostly the hydration that put her back on her feet.  We don&#8217;t know, and it makes a lot of difference to her prognosis.</p>
<p>If it was the antibiotics, and she&#8217;s still got normal kidney function, she might live quite a while yet. The evidence for this is that her bloodwork suggests her kidneys are functioning almost normally &#8211; proteins close to normal ranges, blood pressure not elevated.</p>
<p>If it was the hydration, then she&#8217;s going to need periodic subcutaneous fluid injections to live, and is unlikely to live long.  Evidence for this is that she does seem to be drinking more since the attack of whatever it was.</p>
<p>Dr. Rockwood recommends we start weekly sub-cu, evidently more as a way to take some load off Sugar&#8217;s kidneys than because she&#8217;s diagnosing final renal failure. We&#8217;re going to learn the procedure &#8211; and whether Sugar will tolerate it well &#8211; on Saturday.</p>
<p>Meanwhile, Sugar seems happy.  Not as energetic as the first few days after she came home, which is a concern and tilts towards the hydration-is-what-helped theory, but she&#8217;s alert, not in pain and her appetite is good.  Her behavior is reassuringly normal, which is to say cheerful and touchingly affectionate. On the other hand, Cathy thinks she may be losing weight, which is a bad sign in a geriatric cat.  We&#8217;re both watching her very closely.</p>
<p>The indicators are confusing and mixed, and the range of plausible outcomes is wide. </p>
<p>Hm. As I was writing that, Sugar padded into my office, uttered a greeting meow, and jumped up on the guest chair (a couple feet behind my right shoulder) to hang out. She&#8217;s now purring quietly, enjoying human company and licking any hand that comes within reach. This is what I mean by &#8220;reassuringly normal&#8221; &#8212; and encouraging, if you know that she did that jump up to the chair a lot as a younger cat but had seemed to lack the energy for it the last couple years. Recently she would sometimes ask in cat language to be lifted into the chair.</p>
<p>In some ways it seems like the treatment response to her crisis peeled years off Sugar&#8217;s age. Besides the jumping coming back, the night-yowling episodes we had been suffering through (and attributing to feline hyperesthesia or mild senile dementia) have entirely stopped. She has stopped <a href="http://esr.ibiblio.org/?p=1903">meowing at the mirror</a>, too. We don&#8217;t know what this means. Did she have some kind of slow infection or chronic inflammatory problem that was inducing dementia-like symptoms?   Diagnosis unclear.</p>
<p>Cathy and I are taking it day by day. We&#8217;re giving Sugar plenty of quality time and love.  She seems a little more reluctant to have us out of her sight than before.  I think all three of us are <a href="http://esr.ibiblio.org/?p=2944">stealing jewels</a>.  They seem more precious than before.</p>
