Friday, October 7, 2011

Second Opinion


This is probably more than anyone needs to know, but it helps me to write it down. The cat will soon be back.

I took Estorbo in his unattractive grey box for a second opinion to the emergency referral vet clinic on Warren Street (VERG - Veterinary Emergency and Referral Group), thankfully four blocks away - he's heavy. I did not mistrust the diagnosis from the Cobble Hill Animal Clinic, delivered by phone last night, but wanted another opinion.

We had a long wait, but it was worth it. I was deeply impressed by the manner of Dr. Inbal Lavotshkin,  the emergency vet on duty who examined him first before a specialist  talked to us. She had a very gentle bedside manner, performed a methodical exam and asked a lot of questions. And she shook me by the hand. Unusual in these parts. Then Dr Slade, the internal medicine specialist arrived and promptly sat down on the floor to ask the same questions, before examining the cat again. Then back to the floor for his rundown of the hyperthyroidism, which he felt confident in confirming, based on the physical exam, Estorbo's behaviour over the last weeks (years???) and the previous bloodwork results. He said it was not necessary in his opinion to draw blood again. The cat was very relieved, and so was I. $100 less on the bill. He explained all the treatment options, in detail. Pills, surgery, radiation, gel on ear.


By now, with the helpful feedback of so many of you, as well as my own reading, I know a lot more than I did yesterday, and was able to ask some informed questioned.

I realize that getting this news on the phone last night was not a good way to hear it - as I had no grasp of the condition itself and went into panic mode.

For now the kitty will be on daily medication for about a month to see how he responds. He gets half a pill each time, and they even cut up all the pills before bottling them. Wow. Then we will see about radiation. If it is not radiation it will be pills for the rest of his life. They can be custom-packed in edible gels to encourage him to eat them if we are not around to feed him (if we travel). There are rare side effects, and I will be watching for them.

A heart murmur was detected and they recommended that we return in about 3 weeks to see their cardiac specialist. Hyperthyroidism produces too much thyroid hormone, so everything - all organs - tend to work overtime. (It's not called "hyper" for nothing). It can affect the heart, or this may be an unrelated condition.

It may explain the panting we saw in the summer, when something frightened him and he ran, and arrived home panting like a dog.


What endeared me to these vets was their patient and gentle attitude, towards both human and animal. I find that rare. It was not patronizing, there was no overkill. Technicians in gloves did not materialize to pin the cat down (and scare the wits out of him). They took a lot of time. I was in there for well over an hour. And Estorbo was even given a kiss on his head! That is either brilliant PR on Dr Slade's part, or he just likes cats. I suspect the former, but he's forgiven.

The bill, for interest's sake? $202.00. They did not do bloodwork or urinalysis but they took his blood pressure (normal, surprisingly) and conducted a most thorough exam, talked to me forever and gave us one month's worth of medication. The Cobble Hill exam was very brief, but they did the blood test ($100) and tested the sample I brought ($40). Their bill was $218.

I am a fan. And the cat is asleep.

Thank you to each of you for the good wishes, and for your advice. I never realized how much the support might mean, but it has. I am not a team player. I tend to want to do things and manage things all on my own. But in this case it made a difference to know that others were rooting for us. Thank you very, very much, I have calmed down.The Frenchman never loses his calm. He is wiser, by far.

And Estorbo? He says the eep is mightier than the sword.

37 comments:

  1. In which case, The Horde is eep-ing like mad. As well as purring.
    A virtual kiss for the beeg, blag, Cad from me! (Because I love cats.)

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  2. Much love to you all. This sounds like a well thought out approach. And kisses on the cat's head always endears the vet to me. *smile*

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  3. Yes, sounds well thought out. We like the sound of those vets! If it had been me, I know it really would have been a help hearing from so many who have had cats with this condition who were able to tell you both how common it is and of their successes. As you said, in this case, having "the team" was supportive.

    Best to Storbie! May you all look forward to a less irritable cat! Eep!

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  4. Thank you for letting us know the results and that you feel better about it all..so scary! Our furry friends and family members sure have a way of pulling hard at our heart strings. xo

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  5. Very good news to hear. Love the sound of the vet who sits on the floor and talks calmly and gives kisses.
    And the pictures of The Big Cat, with paws curled comfortably over the table? Priceless(for everything else there's Mastercard! sorry!)

    I daresay now we'll get Estorbo's version...

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  6. Thanks for sharing your experience. If I didn't live in Oregon, I'd be going to your vet(s). My blag girl cad Kiki was just diagnosed with the same thing. So far, she is taking pills...and is very good about it. You hear that, Estorbo? You cooperate with the wooman!

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  7. I had to take Rudy to VERG in the middle of the night a few weeks ago for a stomach bug and was equally impressed by their caring approach. They even called two days later to see how he was doing.

    I know how stressful it is to learn of illness, believe me. Doesn't matter if it is a dog, cat or husband. It's still stressful.

    Anytime you want to talk it out, you have my ear. In the meantime I will continue to pray that Estorbo feels better soon and the medication does what it's supposed to do.

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  8. Marie, my cat has a similar diagnosis. If you'd like to talk about it, please get in touch. Many hugs! Pritha

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  9. Sounds like you found a vet who treats the blag cad and his hooomans. So glad to hear you are more at ease with what is happening. I will go back to lurking but know here at Casa de Cuckoo we are rooting for all of you and will continue sending healing and peaceful thoughts your way. Oma Linda

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  10. Glad to hear that you are doing better and that you have some options for Estorbo. A variety of options is a good thing. All the best.

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  11. Hi, Marie ... Keli'i here. Glad that Estorbo's 2nd opinion went gently on all concerned. I'm especially happy that you feel more informed and empowered about managing his condition. As others have said, if you need to talk about issues as they arise, don't hesitate to email. Chin scritches to the blag cad ...

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  12. Dear Estorbo, Wooman and Smoothman,
    Tino just wants to remind you that people get this also, and live long lives. Since this is only one of your nine, and as cats are superior to hoomans at all times (OK, he'll give them the can opening bit but CATS weren't asked if their food should be put in cans, although it does make it easy to know when food is served), he told me to tell you that you will have a very long life ahead of you. (Oh, and milk it for all you can....) Amy as dictated by Constantino Martinez

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  13. Oh, poor Estorbo! It's clear that he's well loved. And you're so right - we've had many vets. The ones you remember and return to are the ones who clearly love what they do as well as the patients they treat.

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  14. sending you all hope.
    xoKaren (and Henry)

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  15. hermano!!, thiz iz much bettr nooz. yur wooman is takin it like a champ and youze not doing so bad yurself.

    if expeeryeenz is any gyde -- an Mine thinks it iz -- yer gonna be feelin like a noo cad in no tyme at all. [just don't be givin' yer hyoomuns any backfeet 'bowt the pills, the pills is in yer best intrest.]

    go well, amigo, go well.
    yer frend on the maneland,
    halloween
    ~^!^~

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  16. I am very pleased that you have kept us updated. There is a surprising deep caring and love on the blogs. I have learned through the years to be less independent and appreciate the generosity and support that is offered. I would gladly give Estorbo a kiss on the head - and I am allergic to cats! Finding a vet and staff that make you feel comfortable is HUGE. And I imagine you are having some wine or cocktails tonight to continue winding down? I know I would:-)

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  17. I bet the doctor loves cats. Why else become a cat doctor? Estorbo is irresistible and will continue to be so for many years to come.

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  18. Not a team player, hmmm? Like to do i all on your own, hmmmm. Major signs of some one attracted to CATS!
    You have done a service to all of us as well, bringing this condition and symptoms to our attention. Sounds like Estorbo and his peeps are getting this under control. I even shared this episode, along with your blog with my VET here in Philadelphia. I know they'll love Estorbo et al too.
    And the photos are priceless, as always. That one blue eye, cast upwards as he grasps the edge of the table. Uh, too much.

    My boys and I are off to the VET next week. You will all be in our hearts and thoughts, and converstaion. Hope you don't mind! Here's a XXX for Storbie's head. One from each of us. =^..^=

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  20. Well, then, eep, eep, eep, eep from us all.

    And some purrrrrrss to your mom, who seems to love you dearly.

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  21. Dear Marie, You sound so much better today. I am glad that the second opinion went well. I am sending all of my best wishes and positive energy to you, Estorbo and Vince. You are so lucky to have each other. It will all work out. :)

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  22. second opinons count for a lot...and group therapy for quite a bit too..... even though we think we are loners...

    hope Estorbo shows improvement on the next visit to whichever "bed" you choose.... the new guys do sound amazing.... how wonderful. I used to have the most amazing guy for my vet when I had cats...all those many years ago.... I loved him... all the cats loved him... even though my big guy used to still hide under my armpit most of the time...he was 22 pounds and very long..so most of him was not hidden... he was much like an ostrich.... only his head in the sand.....

    hugs to everybody....

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  23. Will you think I'm a little bit nuts if I tell you I got a mite choked up at this post? The pictures of Estorbo looking so chill tell me he really was at the right ved for heem. So glad you got a second opinion.
    Dozens and dozens and dozens of Storbo fans holding their collective breath all over the world are now breathing a little easier...Eep!!!

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  24. Le Frenchman traduira ;-) car à cette heure tardive de la nuit en France, j'ai un peu de mal à trouver mes mots en anglais.
    Soulagée de lire vos nouvelles plus rassurantes que les précédentes. J'ai découvert il y a quelque temps et je suis avec une réelle gourmandise les aventures d'Estorbo même si parfois je suis obligée de me creuser les méninges pour comprendre sa "novlangue". Mais je lui suis reconnaissante de m'obliger ainsi à améliorer mon "catenglish"!
    Je comprends ô combien votre inquiétude pour avoir ici un Théo atteint d'une maladie rarissime chez les chats (dixit the Vet) ou "émergente" (pour nommer savamment une maladie qu'on ne diagnostique que depuis peu de temps mais qui existait avant), maladie qui est aussi un dérèglement hormonal mais des surrénales - l'hyperaldostéronisme - et qui détruit aussi des autres organes (reins et coeur notamment) si on ne la soigne pas. Cela fait presque 2 ans que Théo a 3 gélules par jour à vie de médicaments humains reconditionnés à un dosage chat car ces médicaments n'existent pas pour les animaux. Heureusement il a une forme de la maladie qui apparemment réagit assez assez bien au traitement même s'il faut faire des contrôles réguliers. J'espère sincèrement qu'il en sera de même pour Estorbo. Avant d'avoir les résultats des premiers examens, le vétérinaire pensait à l'hyperthyroïdie car beaucoup de symptômes sont identiques.

    Depuis cet été et après consultation de 2 cliniques vétérinaires puis un hôpital vétérinaire avec spécialistes et scanner, le diagnostic d'une maladie intestinale chronique inflammatoire a été fait pour un autre de mes 3 chats qui vient tout juste d'avoir 2 ans : traitement à vie encore, cortisone, pour soigner les crises. Bref, je suis solidaire du combat que vous démarrez et vous dis : gardez le moral! On croise les doigts et les pattes pour vous !
    Sybee et sa tribu from France

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  25. So glad things are settling down for you. It's very worrying when your beloved pet gets sick and they can't tell you what's wrong. Special blessings on Estorbo and trust he will take the medication without too much trouble. Give him lots of love from all of us.

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  26. I'm SO with you. When you said you'd abandoned your plans to go home to Estorbo and Vince I nearly wept. It was such the thing you needed to do.
    Well done, Marie! You're handling this just as you must and we are all behind you.
    XO

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  27. well the visits to the vet have not affected Storbie's charm - still berber handsome

    yay - you can do this (and I'm sure some stories will be embellished due to his newly diagnosed condition

    si

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  28. The vets sound amazing! Our dog has Addison's and gets compounded Florinef. You might check to see if you would save money getting the thyroid medication via a compounding pharmacy. Hope you and Don Estorbo have a peaceful weekend and that he is better very soon.

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  29. Whew. I'm so glad for you all... the new vets sound wonderful, so the second opinion was definitely worth it. The cat relaxing on the table says it all. I hope the pills work , so maybe the other stuff may not be necessary. Estorbo may soon be feeling better than he's felt in ages! ...and you also :-) Please give Storbie a chin scratch for me.

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  30. Hi Marie y Estorbo. I haven't been following friends' blogs at all but Estorbo's picture flashed past me on Facebook and i had to come read...just at the right time, to reassure you that hyperthyroidism is very treatable. Many years ago my Lesley was diagnosed with it at age 10; she was very difficult to pill, so i finally realized the "radiocat" treatment was the only way to go. She did great! The only drawback was she had to stay at the vet for 10 days while the radioactivity level went down. The vet told me the same thing other people have mentioned, about not sleeping with the cat, but when i said i live in a drafty house and sleep with the bedroom door open, he said that shouldn't be a problem. I had to use a flushable litter and wear gloves when scooping the litter.

    Gingy was diagnosed with hyperthyroidism shortly after coming to live here. She was 9. I wasn't sure i wanted to spend so much money on a cat that i hadn't even bonded with yet. She was fine taking the oral medication (methimazole) but she became allergic to it within a week...so she got the radiocat treatment, too. It's now improved to the point where she only had to stay at the vet's 5 days. And she's doing great 6 years later.

    The late lamented Fuzzy also was diagnosed with hyperthyrpidism. He used to get so terribly car sick, i knew i couldn't take him to the radiocat specialist 45 miles away. Even the sweetest cat doesn't like to be pilled twice a day for the rest of his life, so i tried the transdermal gel...genius! It's in a twistable tube, the gel gets rubbed inside their earflap...i used to do it while he had his face buried in his food bowl and it didn't bother him in the least. The medication (methimazole) isn't cheap...about $30 a month for the rest of the cat's life. The radiocat treatment runs about $1500and the radiocat practice was happy to set up a payment plan.

    I know you've had a terrible scare with the diagnosis coming out of the blue, but it sounds like you've got two good veterinary teams (love the vet who sat on the floor AND kissed Storbo) and it's an exceptionally treatable condition. Best of luck! many purrs from the gang here.

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  31. I have an elderly cat with both a heart murmur and hyperthyroidism. She was diagnosed with the heart murmur a few years before the hyperthyroidism. She takes one pill per day and is doing fine - two years after diagnosis. I hope Estorbo will do just fine too.

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  32. my kitty tumble has a heart murmur and the vet scared the bejeezus out of me by diagnosing it. since then, i have been skeptical of the proposed treatment. (i can't remember what i read, it was so long ago.) 5 years later tumble is fine.

    i am happy to hear this sounds manageable. peels can siempre be wrapped orp een feesh beets when you (the wooman) travel.

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  33. When I took Mr p in for his radioactive iodine, he was 12. At the emergency vet's where they do the process, they found a heart murmer. Apparently this is common with older cats. I chose not to have a cardio consult, and went ahead with the procedure. The only drawback is that if he had gone into distress or arrest, they couldn't intervene because of the radioactive factor. I chose to go ahead anyway, and he sailed through it. It was very hard not to cuddle him when he came home, but by gloving and not putting him right up to my face, we managed just fine. He's now nearly 15 and seems younger than most of the other cats. Also, the weight came back - mixed blessing.

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  34. Beautiful photos (& at the bets no less) of you DE such a handsome, calm & wise, beautiful, beeg, blag kad.

    we wish you well with your tapazole
    we love you Storbee

    xoxoxo les chats de rue leNoire
    Oliver, BleetNess & virgil

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  35. That sounds like a much more reassuring situation for you all. I'm glad you are trying the medication first; I hope it works out, and that you have a chilled, happy cat. (With chilled, happy humans, of course....)

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  36. Oh my, sorry to hear about your big fright over Estorbo's health but glad to hear it's a treatable condition and that you've found a good vet. STERKTE!

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  37. I hope Estorbo is feeling better. I have had cats with all sorts of illnesses but never one with hypothyroidism. If you do continue with the pills, sometimes you can get them less expensively from other sources. I have gotten some of my cats medications from on-line pet pharmacies (Dr. foster and Smith, Lambert Veterinary) but also from people pharmacies. I call them all and get the price since some are cheaper for some things but not others. And sometimes the 90-day supply isn't very much more expensive than the 30-day. This was the case with one of the seizure medications. Also, I don't know if Wahlgreen's drugstore is in NYC but they have a Rx drug card that you purchase for $20. This let me buy saline fluid bags for about $2 each instead of $4.85, the cheapest price I'd found at a pet vet supply house. Good luck.

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