Onslo: Medical Mystery Miracle

Onslo, a straight-earred Scottish Fold is as gentle and sweet natured as anyone could imagine. At 9 years old, he is active, loves to play, and has few health issues except for some arthritis and feline herpes.

In late June, 2009, he became lethargic, stopped eating, had labored breathing, bleeding from his nose, and seemed to have a high fever. We took him to our local vet and, after doing a blood panel, they found him to be extremely anemic and to have a frightening low white cell count and platelet count. Cats are good at hiding problems and we had not picked up on his early symptoms. By the time the we saw the more obvious symptoms, it was a weekend.

Our local vet contacted the UNC School of Veterinary Medicine in Raleigh, NC and we were able to get an emergency appointment for him that afternoon. The 2.5 hr. drive to Raleigh was agonizing and, frankly, we didn't think he would make it.

At Raleigh, he was admitted, placed in ICU and they began to evaluate him. He received IV fluids and about every test one can imagine. When we left him, which was so very hard, they were not sure he would pull through, and we were told that the next 24 - 48 hrs. were critical.

At home, the vets assigned to Onslo's case and the students working with them, called us with regular updates, and, so far away, this was the only contact we had. They were surprised that he was hanging on. A bone marrow test showed no leukemia or bone cancer, and by the third day his white blood cell count and his platelets slowly began to climb. Due to anemia, his red cell count was low and he was given plasma that first night and again during the biopsy.

We began to allow ourselves to hope.

Just as Onslo was beginning to recover, he had a set back. In attempting to get him to eat on his own, vet techs at the school placed him on a bench from which he jumped down fracturing his left front leg. He was not a good candidate for surgery because of his poor white cell count, so a sling was fashioned to immobilize his leg to buy some time.

Within a day and a half his blood count was up enough for the surgeons to do the repair of the fractured leg. Making things more difficult were some heart issues as he had fluid in his lungs and difficulty breathing. The surgery was not a sure bet, and the fact that it was due to negligence frustrated us no end.

Waiting at home for a call that he was successfully out of surgery was pure Hell. But, he made it through that ordeal as well, and the surgeon was pleased with the repair to his leg.

He recovered in an oxygen tent because of his difficulty breathing, but within a day, he was out of oxygen and breathing comfortably. Cardiologists at the UNC vet clinic feel that the heart problems detected are not permanent but part of the incident which caused the anemia, severe infection, and the attack on his bone marrow. They feel there is no underlying heart disease.

One week after being admitted, Onslo came home. He still had stitches from the surgery and a feeding tube to allow us to administer two antibiotics 2x per day. He stayed in a pen to prevent him from re-injuring his repaired leg.

A recheck of his blood count with our local vet one week later showed both his white cells and platelets well up in the normal range and his red cells slowly climbing. All his vets are optimistic that he will make a full recovery and live out a long life. We're counting on it.

So, what made Onslo sick? There is no one definitive answer, but the vets feel that a negative reaction to Clavamox, an antibiotic he had been given about a month earlier for a bite from Daisy, caused an assault on his bone marrow resulting in severe anemia, as well as secondary infections to his lungs and heart.

As a layperson, I have told Onslo's story without a lot of scientific data and in an abbreviated form. But, for those who are interested, here is some of the science.

When admitted his temperature was 104, -5% dehydrated, gallop rhythm and grade I/VI systolic murmur. Severe leukopenia (1,470), intermittent open-mouthed breathing and mild wheezing. Glucose, 162, Axo 5-15, PCV 32%, TS 7.2.

We chose to go to the wall for our Onslo. Every step of the way, he showed us that he had a strong will to live. He amazed even the vets and the hospital staff. All the technicians and students who came in contact with him were very smitten. They went to his web page, downloaded photos, and taped them to his cage.

We do have some insurance on him and on our other 3 fur kids, but it will pay only a small portion. We'll be paying off this bill for a long time to come with many sacrifices to do so. There are no guarantees in life, but, we still feel it was worth it; every cent.

Update, 7/15/09

Yesterday's checkup for our sweet Onz did not go as well as we had hoped. While all his blood values were excellent, his lungs were much clearer, and there was no sign or a heart murmur or other problems, he re-fractured his leg. We feel it was because a student placed his carrier on a linoleum floor and let him out. As he tried to gain purchase on the slippery floor, his injured leg went out at a 90 degree angle. The vet hospital denied that was the cause, but feel this second break was also due to the bone marrow biopsy. He will have surgery on Thursday, 7/16/09, and hopefully come home on Friday or Sat. At that point we will be starting at square one.

Update, 7/16/09

Surgery to repair the 2nd fracture seems to have gone well. The surgeon feels Onslo's prognosis is good but he will again need to be confined and kept quiet. He should be released to come home on Sat., 7/18/09.
 

Update, 7/19/09

We drove out on Sat. to pickup Onslo. Shockingly, when we arrived we found that a vet technician had opened the door to his cage and walked away. Onslo had jumped down and out of the cage injuring the surgical repair. A bed in the implanted pin was clearly visible on the radiograph. We were in shock and hardly able to deal with this latest fiasco.

Driving home, Onslo was quite agitate. Thinking he was in pain, we pulled over and gave him a dose of his pain med. We discovered a dish of food in his cage with him. Who gives food to an animal going on a long car ride?

Onslo's agitation continued and I rode with my hand on him to keep him calm. Arriving home we set him up in his pen and put in fresh food and water. Onslo "dived" into his water bowl and consumed about 1.25 cups of water within the first couple of hours he was home. After a nap, he again had a big drink. We surmise that he was not given water while at the vet hospital; a very dangerous thing to do to a cat that was badly dehydrated only a few short weeks before.

To add insult to injury, one of the students at the vet hospital complained that Onslo was difficult and labeled him a mean cat. We suggested this student would do well to select another career path.

Onslo is scheduled for a check-up with our local veterinary hospital, Animal Care Center of New Bern. He will not be going back to the vet hospital in Raleigh where the depth of carelessness and negligence towards animals in their care is mind boggling.

Update 8/17

Onslo went for a check-up with our local vet, Animal Care Center of New Bern. Radiographs taken showed healing in his fractured leg was not occurring and the pin, bend when he was dropped at UNC State Veterinary Hospital the second time, had moved outside the bone. After consultation with orthopedic surgeons, our vets decided the pin has to come up and that there is a decent chance this will allow the bone to knit on its own. Pin removal surgery is scheduled for Wed., 9/2/09. After surgery Onslo will have to be penned for several more weeks. Poor Onslo has been in his small pen since the beginning of July.

Update 9/2

Onslo had the pin in his fractured leg removed at Animal Care Center, our regular vet here in New Bern. The procedure went very smoothly and he was back home by noon. He has a couple of stitches which will be removed in about 10 days. Then, in a month he'll go back for an X-ray. The hope is that with the bent pin, which was interfering with the healing process, removed, the bone will knit together on its own. If not, he will have another surgery that could involve another plate or an exterior support.

Update 10/13

Onslo had a re-check radiogram at the end of Sept. Although it was clear the bone was finally healing, Dr. Steve felt he needed to remain in his pen until the end of Oct. Onslo is clearly ready to "fly". He invites passing people and furkids to play with him by galloping about his pen with a devilish look in his eye. So, we've started giving him some free time. He and Daisy picked up right where they left off - playing chase and tackle. Today, he was lose on his porch for the first time since mid June and he loved it. He climbed his tower, played with Daisy, and sat on the windowsill watching the world go by. The Scotties were nearby but no one got his or her nose bent out of joint. I think there will be no big deal when he finally has the run of the house and re-joins the pack. Here are some pictures of him enjoying some freedom.

Update 10/27

Onslo had what we hope is his final radiograph checkup here at our local vet, Animal Care Center of New Bern. His leg looks to be almost completely healed and he is now free in the house. No more checkups needed.

We are amazed at how quickly he has gone back to all his old behaviors like begging in the kitchen for food - he is the biggest beggar in the group, finding all his favorite napping places, and watching from the window when I am out w/the Scotties first thing in the morning. I think his yowling for his breakfast can probably be heard throughout the neighborhood.

We had no problems re-introducing him into the pack and life has pretty well returned to normal.

Holidays, 2009

The holidays are here once again and we are so thankful to have Onslo with us. He's a happy boy to see his pal, the Pedophile Santa, once again. If you don't know the story of this little figure, he's an old store window display piece. Don't know how old but he could be 1950s or earlier. He's a bit the worse for wear with a blemish on his rosy cheeks. He's motorized but when he moves, its creepy rather than jolly. He leans forward and reaches out his arms as if he's saying: Here little girl.

But Onslo loves him and they spend a lot of quality time together over the holidays. When we put him back in the closet, which seems a strangely appropriate place for him, Onslo goes through withdrawal.

What We Have Learned

1. You are your pet's advocate. It is all about him. Vets, like doctors, can be intimidating, but you must stand up to them to advocate for your animal. Don't be afraid of being deemed rude or difficult. Be prepared with some mitigating phrases like: With all due respect or I know you want to do the best for Fluffy but, then look them straight in the eye, take a deep breath and Speak Up calmly and firmly. Ask questions and if you don't understand the answers, say so and ask them to repeat the explanation.

2. When a cat has consistently tested negative for leukemia and is suffering from anemia and his CBC shows severe leukopenia, pancytopenia, etc. in order words, his white cells, red cells, and platelets are very low, he is probably not a candidate for a bone marrow biopsy. We were told that fractures after these biopsies are very rare, but in Onslo's case it seemed that the bone was weakened from an attack on the bone marrow by whatever caused his severe illness. As laypeople, we had no way of knowing this, and while hindsight is better than foresight, we believe the vets should have known this. A conservative approach with antibiotics should have been used first. Delaying a biopsy for a couple of days would have shown it to be unnecessary as Onslo did respond to the antibiotics and, if it had been leukemia, the delay would not have changed anything.

3. A negative drug reaction is possible even if rare and should not be discounted.

4. Consider getting pet insurance. It won't pay for everything, not by a long shot, but it is helpful, and may just mean the difference between saving your animal and having to let him go because you don't have the money.

5. If you need to leave your animal with a specialty clinic out of town, make sure they call you regularly. Make arrangements to visit your pet. Provide his own food and make sure they are giving him water as well. Make them understand that you are watching and you care.