Update on Maxine aka She Who Must Be Obeyed

Maxine has the strongest spirit of any cat I’ve had the pleasure to serve. Every day is a new day with her. My husband and I are at the point of saying that we need to “set a date.” But we haven’t. Well, we did briefly. It would have been tomorrow, Wednesday, December 8. Thankfully, it’s not.

Because Maxine’s kidneys have pretty much failed, and she’s become pickier about what she eats, we’ve encountered a problem that we never had with any of the other ten cats that have (or continue to) grace our modest home: constipation. This is where it would be most helpful if she could talk, like in a language I could understand.

About a week ago, we noticed Maxine passed some hard, dry stools. Then, the next day, my husband saw her unsuccessfully straining to pass stool. (Well, she was successful but a few minutes later outside the litter box.) I called our vet, got a prescription for lactulose and started her on it right away. Unfortunately, right away was too late. We thought it was working but then a couple of days went by without any evidence that Maxine pooped.

With four cats, you’d think it would be hard to tell their stools apart. Nope. Not with our kitties. Particularly with Maxine. She never, ever covers her poop. Saturday morning I decided she needed to see a doctor. We had also noticed that she experienced pain when we picked her up, but thought it was her arthritis. Also, as much as she seemed to want to eat, she barely touched her meals. I assumed that while her steroids stimulate her appetite, her kidney disease probably makes the food unpalatable. I got tired of assuming and wanted an expert’s opinion.

I took her to our regular vet during emergency hours. A dog with a chest wound came in at the same time so they referred me to another ER veterinary hospital. I went there. Our regular veterinary hospital currently prohibits humans other than hospital staff from entering the building, but the ER hospital was different which was good for me psychologically. (It was also a mixed bag in terms who did and did not wear a mask. Sigh.)

They ushered me into an exam room right away, and a technician came in to get info within fifteen minutes. I explained our concern about Max being constipated, noting that she has late stage chronic kidney disease. The tech took her to the back to get her vitals and said a doctor would come in to talk to me shortly. I waited.

And waited.

And waited.

After an hour, I asked someone at the front desk for an update.

I waited.

And waited.

After another hour, I went the front desk again, eyes wet from the strain of worry and asked again for an update. The young man came back, said that Maxine was stable and that they were waiting to see if she would have a bowel movement. He explained that a bleeding dog had been brought in and that was why no one had updated me. I thought to myself, “well, I can just take her home if you’re just waiting to see if she’ll do something.”

Another hour goes by.

I ask for another update. Keep in mind, no one of authority has come by to explain what if anything they were doing to or for Max. And I’m sitting in an exam room for three hours, alternating between BBC World and a soccer game … on mute.

Almost another hour goes by and a technician comes in, startling me because by this point, I’m lying on the bench. He’s all smiles and has two estimates for me, depending on what procedures I approve. He asks if they can do an x-ray. Of course, they can. A few minutes later, an actual veterinary doctor walks in. She’s very nice, very calm, but very alarmed at Max’s condition.

She brought up the exams on the TV/computer. Max’s colon was packed full of stool. She pointed out three pockets of gas, places where she likely felt pain whenever I picked her up. I fell apart. I felt so guilty. I still feel guilty. I should have taken her in earlier, so much earlier. Her bowel movements had been changing over the last two weeks, but we thought it was because her diet was changing. By this point, we were giving her subQ fluids every other day, but the vet said that Max was very dehydrated. They wanted to put her on IV fluids, give her an enema, and observe her overnight. I agree to it all.

She felt compelled to discuss euthanasia. If they are successful and Max poops, it’s highly likely this will happen again. Could be a few months. Could be a couple of days. I understood that and asked that they proceed with trying to resolve the constipation. I and my husband will deal with the rest.

I went home, hoping I wouldn’t get in an accident because I was crying.

We got a call late that night letting us know that Max had pooped a little bit (yay!) and she was stable. They had her in a “tower kennel” so she had plenty of room to move around in and a nice, fleecy blanket to sleep on.

I called the next morning. They said she was stable, hadn’t pooped yet that morning (although later records showed she had), and to call back between three and four. I called around four and (yay!) got to talk with the vet on shift. She had had a good poop (yay!) and her constipation seemed to be resolved. BUT. They were alarmed about her anemia. They wanted to keep her longer, possibly do a blood transfusion.

Hell, no.

I explained that Max was already under care for her kidney disease and anemia. I said, “We know she’s failing. We just wanted to get the constipation taken care of.” To say that I know she’s failing was not an easy thing to do. In that case, I was told, I could pick her up any time.

We left immediately.

I’ll say this for the ER hospital. They gave us x-rays and detailed records on Max’s treatment. They could have done better on communication, but it is, after all, an ER hospital.

Max pooped twice for our pleasure soon after we got her home on Sunday evening. She has not pooped since. I have her back on lactulose and her other medications. She is preferring cat food that is mostly broth or gravy so she’s not getting much in the way of solid food right now. Greg is giving her fluids every day. You could say she’s kind of on a fast and that’s why she hasn’t pooped. Who knows. All I know is, if she hasn’t pooped at least a little bit by tomorrow morning, I’m calling her regular vet and see if they will do an x-ray, make sure she’s okay down there.

We had set a date while Max was at the ER and we thought this event would do her in. We’ve tabled the date. We’re back to “wait and see.” I don’t think Max is ready to let go yet. She laid in my lap last night as we watched a movie. It was nice.

Max wondering why she’s having to spend so much time at these veterinary hospitals.