Monday, May 25, 2015

Saving Tyrion Lannister - Take Nothing for Granted

The ups and downs have begun again.

While Tyrion's overall status has been pretty good, concerns are beginning to roll in.  With his possible kidney transplant dangling in front of us, at this point, nothing is still for certain.

His primary veterinarian brought up some things that she and the transplant surgeon had been discussing.  My head spins when I think about them.  First and foremost, he is a small cat, in fact, the smallest cat/kitten to ever be a kidney recipient.  Can you imagine how tiny a 5 lb kitten's vessels are?   Interesting bear fact: a typical cat's urethra (the vessel for urine removal) is only the size of a needle on a flu vaccine.   We won't actually know if everything will "fit" until the procedure is underway.  What we do know is that their transplant surgeon is incredibly skilled.

Cats that require dialysis prior to transplantation also are at risk for mineralization of the aorta (the main artery within the body) - a process I'm not even sure I completely understand. If this has happened, it won't be discovered until the procedure and would exclude him from receiving the new kidney.

Over the weekend he also developed some new symptoms, mainly swelling in the leg opposite of where his dialysis catheter is.  At first there was great concern that he had developed a clot, but a closer look (via ultrasound) revealed nothing.  He still has some swelling, but it has also gone into two other paws/legs, leading to the belief that it may just be that he is holding onto a little extra fluid.  Even the smallest change in his body weight (like 0.2kg) is a HUGE shift for a 5 lb cat. (A clot would also equal disaster for potential transplant).

He seems to feel his best after his dialysis treatments.  He wolfs down his fodo and is alert and awake.

They let him roam around in some of the rooms there so that he can stretch his legs.  We've been told everyone there knows and loves him, that he sleeps in their arms.  That is something that makes me feel better about him being there - he is well loved.

Something else that has to change or correct itself is his white blood cell count.  White blood cells are what the body uses to fight infection.  For some reason, ever since the failed attempt at placing the dialysis catheter into his corkscrewed jugular veins, his white cell count has been high.  As far as we know, there is no other source of infection, because if there were, he wouldn't have been started on the immunosuppressant, a pre-requisite for the transplant.

Speaking of the immunosuppressant...he was getting too much over the weekend and was feeling kind of punky because of it and vomited.  The dose was cut back and he is responding much better to it now.

So, as you can see, things continue to be up and down.  The transplant surgeon will be contacting us tomorrow to go over EVERYTHING we need to know; risks, itinerary, requirements, etc.  It is overwhelming to think about, especially when I only want to think about bringing him home.

I think I've gotten a little ahead of myself regarding Tyrion's homecoming.  I've started clearing an upstairs room so that we can take turns sleeping and working from upstairs, so that someone is with him all of the time.  For the first few weeks, he will have to be isolated away from the other animals and will also be unable to jump (to prevent any abdominal trauma), so we are working on removing furniture and placing a bed on the floor.  That way, he won't be contained to a cage or a small area.  He'll have room to roam and one of his people close.  Then today, I was quickly returned to the reality of it all.  He hasn't even gotten to Wednesday yet.  We don't even know if Wednesday is going to happen. Everything has to be *perfect* to make this a go, and even if it is a go, there are so many unknowns that basically scare the hell out of me.  I think we may have all taken it for granted that this was just going to happen and turn out perfect.  Tyrion has overcome so many other obstacles, initially, this one seemed minor, when it is really the means to the end.  It will be another situation where it either works or he will not be woken up...that is IF we get to that point.  Like Ryan said, despite the outcome, at least will will know that we did everything we could to give this sweet kitty the best chance at life.

It will be another week where we sit on pins and needles.  Getting to the surgery, getting through the surgery and recovering properly from the surgery.  All situations that could go really smoothly or awry.  I am trying to stay positive and saying lots of prayer...hoping that things work out the way they already have in my head.

Little kitty looks a little rough...

Please continue to keep our little Tyrion in your prayers.  It's going to be a rough week, where we will taking nothing for granted.

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