Giving Thanks - especially for emergency veterinary care

Well, our Thanksgiving Weekend certainly went a little pear shaped but it's safe to say we are particularly thankful for the outstanding veterinary care and medical expertise that nursed our little Ella through a serious respiratory crisis this weekend. I'll explain more in a moment, but - even though we ended up having to cancel our own Thanksgiving dinner, planned for holiday Monday with my sister, her boyfriend Mike, Bronwyn and River - we nevertheless had a big dinner on Saturday evening courtesy of our friends, Steve and Heidi, at their new house in Port Moody.


Thanksgiving dinner #1 courtesy of friends, Steve (head of table)
and Heidi (taking the pic), their two girls, Charlee & Andi,
our other good friend Steve (left) and - on the right - me and Lorne. 

Thankfully our hosts didn't constantly bicker and snipe at one-other quite as much this time (our previous visit started to get downright uncomfortable), and their young daughters were just as ignorant and disobedient as usual, so not much change there either. I can't say I've ever once seen them pay a scrap of attention to what their parents say/ask. Similarly, I've never witnessed the parents actually follow through with their own requests or commands either. (Prime candidates for JoJo and an episode of Supernanny.) I sound horribly judgemental and I don't mean to be, but we've had some very stressful meetings with those guys and a lot of it caused by their terrible bickering, cross-parenting and horribly misbehaved kids who have to dominate everything. We were never like that as kids (we wouldn't have dared for a start) and my own nieces and nephews are much better behaved too and actually respect what their parents say.


Delirium Tremens - delicious as a drink
and it also kicks things up a notch
if used in gravy.

Still, it was a fun night all the same and a delicious meal. Not being a turkey eater, I thoroughly enjoyed the spicy vegetarian sausage in mushroom & onion gravy that I brought for myself, especially because I'd poured generous sploshes of secret ingredient into the gravy....namely, Delirium Tremens, a rather  fabulous (8.7% alcohol) Belgian beer. As well as a few drops of ye olde, all-important Lea & Perrin's Worcester Sauce - pronounced Wuster, I might add not Wor-chest-er-shire! That stuff's also great in veggie shepherd's pie.

Personally, (while I know there are a gazillion worse places to live in the world) being stuck way out in the 'burbs has always held zero appeal for me, I can't bear the thought of having to drive everywhere, even to get a carton of milk. Where the closest stores are all your staple big-box monstrosities, the restaurants are tediously generic chains (Cactus Club, Earls, Whitespot and Tim-Sh*tty-Hortons). More importantly, I certainly can't imagine paying over $700,000 for the 'privilege' - in fact, the mere idea of it all sends shivers down my spine. I feel like I'd be giving up on life. If I'm going to pay stupid money just to have a slightly bigger place in the soul-destroying 'burbs then I'd rather emigrate and spend it on a cute farmhouse in the South of France. We pay through the nose to live in Vancouver (and believe me, it does grate on us at times) but we have everything we need right on our doorstep - beaches, parks, shops/restaurants/bars that are independently owned, not just your average widespread chain, plus the added luxury of regular transit, to the point I almost never use the car. If I'm not on the bus then I'm usually walking to wherever I need to go.

That said a family of four would be extremely hard-pressed to ever afford a place in Vancouver, never mind have more than 600 sq.ft. to squish themselves into (which would still cost half a million). And forget the idea of any garden with it - that easily pushes into the $1Million + category, even for a mouldy, rat-infested, condemned teardown. Steve and Heidi's place really is quite nice and is exactly what they've been looking for in a 'family home' - even if it is the kind of suburban nightmare that makes me want to run screaming. Different strokes for different folks n' all that.

So what went wrong with Ella? Our poor little love had a horribly rough time of it this past weekend but is thankfully on the mend. Sheesh, just when we thought we'd finally be free of veterinary visits and having to dish up a daily cocktail of medications...at least for a few more years anyways. (Not that we resent it, let me be clear on that. We will always do whatever is within our powers to help our furry little family in whatever way we can.)

It all started about ten or so nights ago when Ella woke us up in the middle of the night coughing and choking. We gently petted and comforted her until she calmed down enough for the coughing to subside.

Naturally we thought the most likely culprit was a hairball so the very next day we gave her malt hairball remedy (which she won't lick off our finger and wasn't at all impressed with having syringed down her mouth....man, she has an incredibly strong and defiant jaw-clamping instinct). But for several nights in a row, the same coughing fit happened again. We bought malt tablets (which had been pretty successful with Mishka) and tried that. Still the nightly coughing spasm continued, then it happened more than just once a night. By Thursday we became increasingly concerned when it happened 3 times in one night and again the next morning. A hairball would surely have passed by now. Had she eaten something she shouldn't, that's got stuck? We started to seriously think a visit to the vet might be in order, though we also didn't want to be worrying too much (perhaps years of having senior cats in various states of physical decline has made us a little over-cautious in this regard?).

By Saturday morning - after several more coughing/wheezing fits during the night plus a couple more that morning - there was no denying it, she needed to see a vet - ASAP. We couldn't risk things getting any worse and especially not on a long weekend, since that would leave 24hr Animal Emergency as our only veterinary option. We managed to get a 3pm appointment to see Dr. Kramer at  our regular vet - the first time we've taken Ella there - and she even threw up during the car ride, maybe due to the stress from coughing.

Dr. Kramer's seen us many-a-time before and generally under pretty grave circumstances. Her gentle examination of Ella revealed a healthy heart but slight crackly sound in her chest. Two subsequent x-rays indicated over-inflated lungs, a slightly flattened diaphragm and a noticeably accentuated outline of the bronchiolar tree, including 'donut' patterns - all typical signs of respiratory distress, most likely asthma.

Given our limited knowledge of Ella's previous health history (having only adopted her in May) Dr. Kramer also ran a blood test to check for FIV, Feline Leukemia and any signs of infection - or it could also be parasites or heartworm. She also administered a steroid shot (prednisolone) that would last 24hrs and would settle Ella's breathing down and be a good indicator of whether asthma really is the problem. The injection definitely helped. Even though Ella was somewhat subdued after her ordeal, she wasn't coughing and didn't cough that night.

Waiting for news on the lab results felt like a far too familiar and well-trodden pathway. While Lorne was able to stay more optimistic, I couldn't help inwardly fearing the worst. Thankfully, when Dr. Kramer emailed us Sunday morning, she confirmed the lab-work came back and the results looked good. (And breathe........) She suggested we make a follow-up appointment for Tuesday to discuss treatment options. Unfortunately we didn't get that far before poor Ella started to have coughing fits again - with increased frequency and intensity.

By Monday morning she was in very rough shape, coughing far too much and too often, lying under the bed all hunched over and showing laboured breathing. We clearly had no choice but to take her down to Animal Emergency. Without even showering, I threw some clothes on, stuffed Ella in her carrier and drove down to the ER. Lorne stayed home to prep the veggies for the Thanksgiving meal we'd planned - Vicky and co. would be coming over at 3:30pm.

It was crazy-busy at Animal ER, I had to park a couple of blocks away. They operate a triage system just like a human ER, so I was both glad and alarmed when they immediately bumped Ella to the front of the queue. They took her into the back, gave her a sedative to calm her down (from the stress of the respiratory difficulties) and put her on oxygen right away.

I waited....and waited.... and waited. Animal Emergency is a tough place to hang out, especially when you're a crazy animal-lover like me. So many puking dogs, an elderly beagle that couldn't/wouldn't walk, a cat with a yukky eye infection and a golden lab that literally had tyre tracks on his side from the car that hit him just 10mins earlier. Even the phone was ringing off the hook. But perhaps the toughest was the when a young woman with (what I imagine was) quite severe cerebral palsy drove in on her mobility scooter transporting her adorable little poodle/bichon frisee. I got chatting with her while I waited for Ella. Turns out her dog was 13 and the past two days he'd started crying out in pain, didn't want to move, stopped eating and generally didn't want much of anything. This coming right after she'd also had to put her 14-year old cat to sleep just three days earlier. Horribly sad. (Heck we lost a cat a year the past few years and found that difficult enough, never mind the thought of two within a week.) Her poor little dog was heartbroken at the loss, they'd been inseparable and had spent years always snuggling and sleeping cuddled up together. Now she feared the worst for him and, to be honest, it wasn't looking good :-( I almost cried. My heart went out to her, and to her little bundle of fluff.

I waited two hours at ER, while they kept Ella on oxygen and took a couple more x-rays (as seen above). The vet asked whether, in my opinion, anything looked different compared to those taken 2 days earlier. While I'm no expert, I'd definitely say her bronchioles looked a little more accentuated. She felt Ella was doing better but nevertheless wanted to keep her a few more hours, possibly even hospitalize her overnight. In the meantime they'd email her x-rays to a clinic in the US for secondary evaluation to rule out anything more serious. They suggested I wait at home and phone in later - or they'd call me.

It was about 1:15pm when I got home and Lorne had prepped most everything for dinner.....but we both determined, quite reluctantly, that it would probably be better to postpone. Bugger, because we were so looking forward to Vicky, Mike and the kids coming over - it's been ages - but with Ella still at ER and, even if we did get to bring her home, she'd need quiet, calm and perhaps a little solitude after this whole ordeal. I was quite bummed out having to cancel, but what could we do? Our plans had been completely side-swiped - we certainly didn't see this one coming. So we postponed until next Sunday - which left Lorne and I a LOT of vegetables to eat over the next couple of days.


Well this should be fun
trying to get Ella on this.

By 4pm (and a lot of nail-biting on my part) we were told we could collect Ella and bring her home. They were happy with her progress and didn't feel the need to hospitalize her after all. They discharged her with two sets of oral medications: Prednisolone (an oral corticosteroid) and Terbutaline (a bronchodilator). They'd rather get her onto an inhaler (you can get inhalers for cats? Yes, apparently something like this, by AereoKat) but they were out of stock.

For the first time in (just) 6 months, we're back to the old familiar, twice-daily routine of rattling pill bottles and stuffing medications into Pill Pockets (amen for Greenies Pill Pockets!!!!)

So top of our list of things we're truly thankful for this Thanksgiving weekend are:

• Our Ella-Bella-Boo is still very much alive and doing well
• Emergency veterinary clinics and the incredible staff who work there
• Access to expert medical attention 
• Advances in medications for cats
• Pill Pockets to dispense said medications without losing an eye or finger
• Having the financial means to be able to treat our beloved furry family and truly take care for them. It doesn't come cheap, that's for sure - we quickly devoured $1,000 this past weekend - but I can't imagine how heartbreaking it must be for those who have to legitimately decide between food on the table or veterinary bills.
• The support and understanding of my sister, Victoria, when we had to cancel dinner :-(

I'm pleased to report the medications are working well - Ella's been cough-free since Monday and is doing really well. We're booked to follow up with Dr. Goldberg this Saturday so we can figure out a short, medium and long-term plan for her asthma, ideally a mix of inhaler and perhaps homeopathy.

Dr. Kramer left a phone message on Tuesday to check in on Ella, having heard that we ended up at ER with her after all. Part of me just wishes she could have sent us home with an extra syringe of prednisolone when we saw her on Saturday, just to get her through the long-weekend, especially since she knew the dose she'd given her would only last 24hrs. Perhaps we could have saved ourselves - and Ella - this whole ER trauma and serious respiratory distress (not to mention the additional $500). That said, the more forgiving side of me feels that we couldn't really have predicted just how quickly this asthma attack would take hold and escalate to such a dangerous level.

I believe Ella might be down a life now. I'm incredibly thankful for all the help that saw her pull through this traumatic turn of events and we intend to make her eight remaining lives long and wonderful.