Cara's Journey: In Sickness & In Health

It's been a VERY LONG JOURNEY for Cara Melle-one I wonder will ever come to a happy conclusion. Cara's been sick for SEVEN MONTHS. When we cure one issue, another problem pops up. We've squeezed everyone's pockets to shake loose every last penny. This little kitten has cost my rescue group thousands of dollars in Vet care. This is not about the money, but it is an illustration of how far we've travelled to find a way to get Cara HEALTHY.

©2011 Robin A.F. Olson. Cara knows she's at the Vet. Been there, done that, one too many times now.

There've been a few times when we thought we had Cara's problems licked. At first, it was a terrible URI that permanently effected her brother and sister. They both have scar tissue in their tear ducts which slows draining of their tears and causes them to have one or both eyes weep. They won't suffer much as a result of this, but it's a reminder to us of what they went through, too.

©2011 Robin A.F. Olson. Those big eyes just cut right through my heart.

Cara, however, was hit the hardest. She had two esophageal strictures from being burned by Doxycycline when she was just a little kitten. It was avoidable had we known the antibiotic was so acidic. It could have been caused by her genetics, too. We'll never really know for sure. Either way, it caused her tremendous suffering, for a very long time. Her growth was stunted and she remains underweight.

We treated her strictures twice and medicated her every six hours for weeks. We gave her “novel protein” diet to make sure she didn't also have a food allergy (turns out she did not). We gave her the best food, the most love and tender care, but it was not enough.

©2011 Robin A.F. Olson. Cara's resemblance to her mother, Mazie is very clear. Mazie still waits for her forever home, but was very glad to see Cara again.

Cara continued to vomit-PROJECTILE vomit. If you've never seen that before, imagine a hose being turned on inside little Cara. The spigot flies open and a torrent of fluid comes out. It's shocking. Disturbing. Horrifying. It leaves Cara limp. She rarely ever plays. She sits hunched over, uncomfortable, licking at her mouth, her tummy grumbling.

On Friday Cara returned to see Dr. K. Our last three weeks of feeding her a special diet showed us she had no food allergies, but she was still vomiting. A repeat of her blood work revealed her White Blood Count was still shockingly high at 29,500. Dr. K needed to do a third endoscopy to find out what was going on. The results surprised all of us.

While Cara's strictures were healed, her stomach lining, which was once fine and normal, was now “grossly” full of Helicobacter. To understand how common this is, here's a portion of an article by Bob Sherding in 2001

“Various surveys have found a high prevalence of Helicobacter approaching 100% in most shelter and colony cats and 30 to 100% in pet cats. The spiral organisms identified most often in these surveys are the large Helicobacter-like organisms, e.g., H. felis and H. heilmannii. Because of the high prevalence of infection in animals without clinical signs, the clinical significance of gastric Helicobacter-like organisms (GHLO) in cats is uncertain. Helicobacter organisms may be an incidental finding in clinically normal animals, but when they are associated with clinical signs (chronic intermittent vomiting) and gastric mucosal inflammation (lymphocytic gastritis), it is possible that they should be considered potential pathogens and treated.”

The treatment remains the same-even today: Amoxicillin and Biaxin™

But that's not all Cara is dealing with. She also has Leukocytosis-which is a high White Blood Cell Count. Because her Neutrophils are also high, it means she probably has a nasty bacterial infection. Last month, Cara had a high Eosinophil count, which could have meant she was having an allergic reaction to her food or medication. That indicator is back to normal, so it leads us to believe that Cara has a “Mother” of an infection.

What causes this? Another mystery. Helicobacter is common. It making us or our cats sick, is not so common. What caused Cara to have such an overwhelming infection leaves us all scratching our heads. All we can do is treat her and hope it resolves. She may get better or she may get this on and off for years to come.

The saddest thing to consider is that this infection can be a precursor to Adenocarcinoma or Lymphoma. Adenocarcinoma is always malignant. My cat, Bob, has lymphoma. It can be treated, but there is no cure. To think that Cara, at such a fragile age, could face this one day is unbelievable and completely cruel. I hope it is not so. Today it's too soon to tell.

Cara's endoscopy. Tough to see here, but her stomach lining is a mess.

And then there was Cara's pancreas to consider. Either it was inflamed and getting worse, or it had been and was resolving. They ran a PLI test to determine how badly her pancreas has been effected. This is in a EIGHT month old KITTEN. To have such problems is disturbing, gut-wrenching and heartbreaking.

Cara's pancreas shows white highlights. This means it's inflamed and irritated. Is it getting worse or is it getting better?

Who will adopt a kitten with such health history? Who would I even TRUST to give this kitten a home? We have a long way to go before we can even worry about that. Right now there's much to be done, but the fear sits in the back of my head. I don't know that Cara will ever be on Petfinder looking for a forever home.

Sam was able to drive with me down to Norwalk to pick Cara up after her procedure so I could hold her on my lap the entire drive home. She was very weak and withdrawn. Although she had a nice reunion with her Mother, Mazie and sister, Polly, Cara wanted to be alone, to rest. She ate well for me the first night, then the next day, back at her foster home with Aunt Connie, she stopped eating. Her coat was rough. Her left eye was now weeping from the URI. She hid under the sofa where no one could get at her.

©2011 Robin A.F. Olson. After endoscopy, Cara is wiped out and sick with a URI.

We had to give her antibiotics, so after some coaching, were able to get her to come out so we could treat her. It took two long days, but Cara started to turn the corner just a bit. She began to eat some food and came out from under the sofa. Her eye stopped running, but she was still very worn out.

©2011 Robin A.F. Olson. Cara looks out the window into the darkness. She didn't want to visit with us. She just wanted to be alone to rest and try to recover from the procedure.

This morning Cara projectile vomited again, so I called Dr. K. to let her know. She said the infection was so bad that she wasn't surprised there was more vomiting. She said to stay the course, keep giving her the meds and give it a week. By Saturday, maybe she'll show signs of feeling better. We can only hope.

I have no idea what is to become of Cara. Once her meds are done in two weeks, we'll re-evaluate the situation. If Cara is responding well, then what? I don't know. Will Cara get something else? We she relapse? Will she even live to be an adult?

Cara looks right into my soul with those big owly eyes. She's so much like her Mother that way. I only wish she was just as healthy and ready to be adopted. For now, all we can do is keep our commitment to her, in sickness and in health, for better or worse.

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If you'd like to read more about Helicobacter, how common it is, how it may be transmitted and its' effect on humans, you can read this article on DVM360, as well as on Wikipedia