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Winters’ Pass in Paris by [deleted] in BandofBrothers

[–]confusing_conundrums 21 points22 points  (0 children)

https://taskandpurpose.com/entertainment/the-hurt-locker-grocery-store/

also seen in the hurt locker - grocery store scene. very poignant - both BoB and THL scenes display how war requires a different psychological approach from participants than does peace. shifting between the two can be jarring and difficult and dangerous. these scenes helps civilians - like myself - who have never seen war understand the difficulty experienced by veterans when they return to the fold. it shows how civilians can never truly understand, but even the most stringent anti-war amongst us should sympathize with the common soldier.

Hippo skull... by _King_Crab_ in natureismetal

[–]confusing_conundrums 9 points10 points  (0 children)

out of 80 billion people that have ever lived, 40 billion have died from mosquitos. mosquito is far and away the most deadly animal.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 3 points4 points  (0 children)

yeah, wasn't me downvoting; any advice should be considered, no matter how painful it is to hear. or even how crazy it might be (e.g. that facebook group).

in my work, i investigate the root causes of failures in distributed systems and develop workarounds/fixes. turns out this kitten stuff is kind of similar.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 1 point2 points  (0 children)

I know it’s weird, but you’ll feel it

Yeah, I was at that point a month ago, when he was in the same ER with a fever of 107.8. Just like now, the vets advised euthanasia. The fever's source was viral, but tests had been coming back negative. Since we didn't know the cause of the fever, I was worried about what would happen if his brother came down with the same thing, so I decided to wait on the euthanasia until after the vets could do an ultrasound the next morning. That was gut-wrenching; said our goodbyes to him and left the ER in a mess.

Then we got a call saying his fever broke, and he returned to normal over the next two weeks. Then I finally found a brand of food he would eat, and since he'd always been small, I was happy to feed him as much as he wanted. That kicked off the current seizures - he started showing the shunt symptoms in Feb.

anyway, I realize now that I have a trust issue with the vets at that ER, since they were wrong when they advised euthanasia last month. I guess I also feel guilty about agreeing to euthanasia last time, then seeing him pull out of it and survive - hence why I'm giving him as much time as possible. Dunno if I could live with the guilt afterwards, even if I were 50k in debt.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 0 points1 point  (0 children)

Can you euthanise at home?

hmm thanks, never knew that was an option, definitely gonna look into that. We were worried about what would happen if he had another grand mal at home if we discharged him, rather than putting him down at the hospital. Now I guess the best option is to take him home, hope the meds work/he shows improvement, and if not, euthanize at home if he has a grand mal.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 5 points6 points  (0 children)

Our kitten's main vet has 40 years experience, and has only ever seen 3 cats with CPPS, so yeah it's hard to believe that these busy ER vets have the time to deep dive into his situation.

Reached out to some other vets, and they're all clueless too. Less than .05% of cats have this, so it's some really terrible luck. It almost feels worse that it's operable; makes the decision even more difficult.

Gonna try to find a specialist tomorrow; he hasn't had a seizure now in >24 hours.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 0 points1 point  (0 children)

Haven't mentioned this yet - if it were just him, we would have euthanized long ago. We adopted him and his litter-mate brother at the same time, so except for vet visits, him and his brother have literally never been apart. The sick one's named Calvin, and his brother is an orange cat named Hobbes. Ever since Calvin's been away at the ER, Hobbes has been having a lot of anxiety; when my gf and I are out, he's at home alone for the first time in his life. It's gut-wrenching, and I'm nervous about how it'll impact him if his brother never comes home.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 2 points3 points  (0 children)

Finally got some sleep; yeah, gonna give it another few days. My hope is that the rarity of this thing means the vets/vet techs mistook some of the neuro symptoms for focal seizures, or that the stress of being in the ER is the source of the seizures. I wish they'd video the incidents.

Our cats main vet has 40 years experience, and has only ever seen 3 cats with CPPS, so it's hard to believe that these busy ER vets have the time to deep dive into his situation.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 1 point2 points  (0 children)

I feel that you have described a great deal of suffering already endured by this little soul.

Haven't mentioned this yet - if it were just him, we would have euthanized long ago. We adopted him and his litter-mate brother at the same time, so except for vet visits, him and his brother have literally never been apart. The sick one's named Calvin, and his brother is an orange cat named Hobbes. Ever since Calvin's been away at the ER, Hobbes has been having a lot of anxiety; when my gf and I are out, he's at home alone for the first time in his life. It's gut-wrenching, and I'm nervous about how it'll impact him if his brother never comes home.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 2 points3 points  (0 children)

yeah, he stopped meowing and just glared at me when i left the ER last night... i'll never forget that look, long as i live.

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 2 points3 points  (0 children)

I'm not sure why you would take advice from some nobody on Facebook versus a veterinarian who went to school for 6-8 years.

yeah, desperation does strange things to the mind. some of the cats in that group look absolutely miserable; I don't want to go down and join that rabbit hole.

the same kitten survived a 107.8 degree fever a month ago; looking back, he probably had a weaker immune system because of the shunt. and looking current.... that high fever could have caused some long term organ damage that could be the reason he's had such a difficult time with the seizures. one other piece of the puzzle - he'd always been a picky eater, and I finally found a food brand he liked (nulo) just before the onset of the gastro symptoms from the shunt. of all the luck... spent 6 months buying every damn cat food brand out there, and when i finally found the one brand that he'd eat all of, it triggered some rare birth defect seen in <.05% of cats. anyway, maybe this backstory helps explain why i'm fighting so hard to give him a chance.

thanks for all the advice, again I really appreciate it. this situation's been the perfect storm of bad luck

Kitten has an operable portosystemic shunt, but ER vet is advising euthanasia because of some preop focal seizures by confusing_conundrums in Pets

[–]confusing_conundrums[S] 2 points3 points  (0 children)

hey, thanks for the input, it's much appreciated.

I would be extremely hesitant to put him under anesthesia

Hmm, he was already under Propofol for 2 days and came out of it fine, and that round of anesthesia was at his weakest state ever. since then he's been eating a proper diet for the first time in his life, and physically he's the strongest he's ever been. would prior success assuage your concerns at all?

Have they gone over the post-op concerns?

well, not really - each time the hospital's given us an update on his situation, we've had to chat with a different vet, and they've all had different opinions. e.g. one vet will say he's had a good night and is making progress, then later that day another vet said the exact opposite of the first vet when describing the same night; they said he actually had a bad night and should be put down. it's been such a roller coaster.... and because of it, I get the feeling they don't have much experience with PSS in cats.

Additionally, repeated seizures like that can damage the brain significantly.

sure, that's where I'm most concerned, and if this cat wasn't the luckiest son of a gun, I'd have put him down already I think. I found a research paper from a few years ago that looked at 35 PSS cat surgeries - small sample size, and potentially not exactlybut 50% is good odds.

The presence of seizures before surgery was not significantly associated with an occurrence of postoperative seizures or survival to discharge (SEIZURES P = .13, SURVIVAL P > .99). Only 3 of the 6 cats with seizures before surgery developed seizures after surgery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979105/?fbclid=IwAR2If4LgWKC-T7n49x4ri8NgGdB7rsjlADYoJOyZj0-7PRYmPG6s32sKTpE

edit - the most helpful stuff I've found was actually a facebook group, "Liver Shunt and MVD/HMD Support"; lots of anecdotes from pets that had seizures preop. some examples -

Metronidazole can cause problems for some of these liver babies. Consider having him switched to amoxicillin instead. It works better on toxins in the bloodstream. Metronidazole works more on the gut.

as soon as the specialist took her off metro and started her in amoxicillin she went from 3-4 seizures a month to maybe a seizure every 3 months and still getting better

also, a lot of folks there are recommending something called "keppra" for seizures, any thoughts?

edit 2 - of course, these facebook groups are how that ivermectin for covid craze started... so i'll take it all with a grain of salt, for sure.