Saving Tyrion Lannister - The Roller Coaster Ride

Tyrion’s care remains a roller coaster of events.  One good thing continues to be followed by 2-3 worrisome things and those things are usually very worrisome.

Yesterday was one of those days.  Tyrion’s vet, Dr. Cleroux, called around noon, which was unusual to begin with.  She said she had a number of concerns (mind you, these concerns are never minor).  Tyrion had been bleeding around the dressing that surrounded his dialysis catheter, he was losing blood in his urine and stool and had a hematocrit (the red cells that carry oxygen in our blood) that was dropping as fast as it could be replaced.  Through yesterday, Tyrion had received a total of 9 transfusions, which is a lot even for their hospital.  Something about this that is of growing concern is because of all of those transfusions, will he be able to match to a donor cat?

For some reason, he just would not clot at the location where his catheter was; he was saturating several dressings over a short period of time.  While the site wasn't “gushing”, it was still leaking consistently.  To make matters worse, he needed dialysis, which posed a problem of its own, as the blood has to be thinned with an agent called Heparin, to allow for good flow and prevention of clots during the dialysis process. With blood oozing from his catheter site, thinning it even more was not something that was going to bode well for him at this point.  On top of all of this, he just wasn’t feeling well. 

Once again, he was at a point where we were forced to make last chance efforts.  If those efforts did not correct his issues, we decided that the only fair choice to him would be to let him pass.  Needless to say, yesterday was another really hard day.  If you remember, the day before was a good day.  One step forward, four steps back.

Dr. Cleroux presented us with a choice of using a medication that did not have any evidence based research showing any results in cats, but had good results in humans called DDAVP.  We hoped this would help his kidneys stop producing blood in his urine as well as help him with clotting as well as increase his blood pressure.  His low blood pressure was likely a cause of low blood volume (from the leaking), yet another reason he couldn't have dialysis.  So we did it.

Thank God Dr. Cleroux called with decent news this morning.  Some combination of the DDAVP, a plasma transfusion he received, a pressure dressing to his leg or the dialysis he was able to receive later in the day worked.  His catheter site has stopped oozing blood for now, he no longer has blood in his urine or stool and his hematocrit is holding steady (but still about half of what it is supposed to be).  He was able to have his dialysis late yesterday and finished around 7am EST this morning.  The great news today was that his renal values were actually NORMAL!  Not super high, semi high, but normal.  Dr. Cleroux said she could see that he was feeling better as he ate a little bit this morning and was licking/bathing himself; two things he hasn’t done in a long time. 

We’re still waiting for the rest of the infectious disease tests to come back to clear him for transplant, hopefully we will have some good news on Friday as well. 

Once again, the power of prayer amazes me.  I feel like this little kitten has so many friends, family members and even complete strangers pulling for him, that he just cannot let anyone down.  He is a true Tyrion Lannister, fighting the fight, overcoming when we worry that might not.  He continues to surpass my expectations.

Tyrion certainly isn’t out of the words by any means.  We still have challenges.  One that is concerning is completely out of our hands.  With as many blood transfusions as he has needed, Dr. Cleroux was concerned about their blood bank running out of blood that he is compatible with.   I pray that the time never comes when he really needs it and it is not available.  I pray that they are able to replenish their supply; not only for Tyrion, but for the other pets they treat as well.  I pray that we are closer to getting the transplant he needs.  That *maybe* the week after next it is his turn.  But most of all, I pray that he comes home.

 

Addendum:  So I wrote this post around noon.  Things have shifted yet again.  Tyrion received a plasma transfusion this evening and had another mild reaction to it.  This becomes more concerning as he continues to need transfusions.  While the reactions have been mild, a fever with some slightly labored breathing, they still pose just another potential problem in his care.  He ate again this evening and the sores in his mouth and GI tract are likely healed, but those are not even on the top 3 list of worries right now.

So another night of worry unfolds; we sit with heavy hearts.  Hopefully there will be some better news in the morning.  Getting a new kidney for him isn't as easy as it sounds.  Sometimes I feel like that day will never get there, but I have to hold out hope.  I battle with a lot of feelings such as 'is this fair to this little kitty'?  Well....no.  It's not fair that this poor little thing has these majorly big issues, but what is fair is that he is getting his best chance at life.  I also wonder how much his little body can take. Tomorrow will likely be another wild ride as it will involve another transfusion, another chance of a reaction and other obstacles.

Continue your prayers for our little kitty, they have already proved powerful.  We need him home.