Thursday, May 7, 2015

Saving Tyrion Lannister

Last November, we decided as a family that we wanted to welcome another kitty into our brood.  After careful selection, we found an adorable kitten that was for adoption through the SPCA and it was pretty much love at first sight.

While our other kitty Khleo, wasn't exactly pleased with these new developments, eventually she grew to love her little brother.  Our little family, fur and skin was complete.

Tyrion, who lived up to his character's name (we love 'Game of Thrones'), was always a small kitty.  He didn't grow that much in the five months we've had him.  We thought this was a little odd, but just chalked it up to him possibly being a small cat like his sister Khleo.  Over time we noticed he was becoming more sleepy.

Instead of going up to Ryan's office to hang out with him at night (vampire hours), he was cuddling up with me when I went to bed (which I didn't mind at all).  We again, discounted this and thought that he was just growing.

These two have the most unique bond, but he still likes my breath better. :)
But this past Friday, things started falling apart.  Ryan noticed that little kitty (Tyrion) was staring into space, we were finding him in areas he'd never gone in our house before and he wasn't getting overly excited about food or coming when called.  He was a very veracious eater, but last Friday, he didn't come when called...his call was shaking a bag of treats.  This kitty has always come when called.  We think of him more like a dog than a cat.  He is always in the dog food, our food and his food and now he wasn't.

The evening before Tyrion started showing more signs he was not feeling well.

We decided that maybe it wouldn't be a bad idea to take him into a 24 hour vet.  We drive down to Hillside Veterinary Clinic in Dallas and I was fully expecting to learn that maybe he had an eye infection (he had some dark matter in his eyes) and was possibly a little dehydrated. We nearly took the vet's advice of conservative treatment of sending him home on fluids that would be administered through a subcutaneous injection and some medication to help stimulate his appetite.  For some reason, in a twist of fate, we thought maybe we should go ahead and at least get some lab work, a complete blood count and a kidney profile at the least.  What we learned next can only be described as shocking.  Tyrion was in kidney failure.  At 8.5 months old.  He was also severely anemic.  Little kitty's gums were white as was his nose. His hematocrit level (one measure of red blood cells) was 10.  Normal levels are around 35.  We new he would need a blood transfusion, but that posed another problem.  There were no available packed red cells (the type of blood he needed) at this particular vet and none to be found/available at surrounding vets.  We were desperate.  In an incredible act of kindness, one of the veterinary techs at Hillside, Jesse, volunteered her cat to be a donor for Tyrion.  Her kitty provided him with two lifesaving transfusions, but we were still getting nowhere.  His levels continued to peak and then drop.  The vets at the practice were confused, as were we.


We received a call Saturday morning from the vets stating his condition was not improving.  They would continue to monitor his kidney function and level of anemia.  None of these numbers improved during the day, in fact, they got worse.  By the time we got down there to see him Saturday evening, he was being prepped for another transfusion, his third.  This time another vet tech whose name we never learned, volunteered her cat, Mittens, who looked like an older, fluffier version on Tyrion, to be another donor.  When he saw us, he perked up a little bit, but he was still very lethargic.  He was sleeping in his litter box, but did eat a little bit for us.  The first food he'd had in awhile.  We left feeling defeated.  This poor little kitty wasn't getting better, in fact he was getting a little worse.  He was unable to receive any fluids at that time as they didn't want to dilute the fresh blood he'd just had.  He was being tested for anything and everything, looking for a reason for his kidney failure, which is odd in such a young cat.  His symptoms have never fit into a neat little box of symptoms.  We always knew he was kind of a weird cat, in an endearing sort of way.


Sunday brought some difficult decisions, a great deal of tears as well as worry.  We felt there was nothing more Hillside could do for him. We had a sonogram done, which didn't show anything terribly significant, which left us even more confused.  We made the decision to transfer him to a critical care facility in Lewisville, the Center for Veterinary Specialty and Emergency Care.  We were told this facility housed the best of the best veterinary nephrology (kidney) expert in the area.  We rushed him to Lewisville where he was re-evaluated.  Even though we had no idea what was going on inside this little guy, we were told his only hope for survival was renal dialysis, something that is also performed on humans with kidney failure.

This was a very trying decision to make.  On one hand, I didn't want my poor little kitty having to live with tubes sticking out of this neck and having to be fed by a feeding tube, but on the other hand, both Ryan and I wanted this kitty to have the BEST chance at life.  We discussed how very special this kitty is to us.  Tyrion isn't just our pet, he's part of our family.  We had to think about what we would do for any other of our family members.  Because the Lewisville facility was only equipped to do dialysis on larger cats, with larger dialysis catheters using a higher quantity of blood, we were advised to possibly pursue treatment at the University of Pennsylvania in Philadelphia as the treating physician, Lisa Thompson (who is the BEST in this area), was familiar with their program and knew one of the heads of the department.  It was an option, but we just weren't sure yet.  We wanted to see how he did through the night.  When we left Tyrion, he was quite playful.  He didn't even look sick.  He was rubbing his cheeks on our hands like his normal self.  He's always loved smelling my breath (I told you he's a *special* cat) and he was doing just that.  It was hard leaving him.


Monday morning brought no new answers, few changes in his condition other than that little Tyrion's potassium level was climbing because of his kidney's inability to perfuse correctly; a condition that could ultimately send him into cardiac arrest.  We quickly decided that U Penn would be his best shot.  So we purchased a plane ticket for Ryan and he was off to Philly just 4 hours later.

Saying our goodbyes.

Ryan arrived at U Penn that evening and Tyrion was taken into their care.


We wanted to dialysis to start right away on Tyrion just for the sake of getting him to feel better, but several things had to happen before that could begin.  Because his kidneys were not working well, he began accumulating fluids in his lungs.  The veterinary team had to aspirate the fluid (through a small needle) and collected nearly 1/4 of a cup.  Keep in mind Tyrion is a 5lb kitty!  He still had fluid on the right side of his lung, but started to fuss during the procedure and the team did not want to push him.  Another day was about to pass without getting this little guy on the dialysis treatment he needed. Ryan was able to stay in Philly and was able to see him once that day.

Tyrion on Tuesday

His kidney values were holding and not getting worse.  We were able to speak with one of the department heads, Dr. Foster, about Tyrion's care and began to feel comfortable with their plan despite the fact that he still was not on dialysis.  A decision was made that he would be prepped the next morning for the placement of his dialysis catheter.


Tyrion's procedure was delayed because of other emergencies.  They did not start the catheter placement until around noon.  During this time he received yet another blood transfusion...another mystery to us.  Where were these red blood cells going?  We knew he had likely developed a small ulcer in his upper GI tract (I'll spare you the details), but that was not a good explanation.  His belly was not full of blood.  The catheter placement started around noon and around 6pm we received a call that it had been unsuccessful, despite the best efforts of the some of the best veterinarians and vascular surgeon.  This was a crushing blow to the hope that we had that he would get dialysis soon.  His jugulars, instead of heading down a straight path to his heart, both took corkscrew turns (again...,.a "special" kitty).  We were once again back at square one.  During the procedure, they WERE able to tap over an additional 1/2 cup of fluid from the right side of his lung, something that would enable him to breathe much easier.  The renal veterinary team, with the best of the best feline vets, would come together on Thursday to discuss the case and the next steps.


Thursday was a rest day of sorts for Tyrion.  No poking or prodding.  The team was able to place a endotracheal tube that would allow him to receive liquid nutrition, something he desperately needed as he hadn't had any sizable intake since the week prior.  Thursday afternoon, the vets convened to discuss Tyrion's case, they will update us Friday morning.  He didn't get any worse on Thursday and his potassium level was actually coming down a bit, but he also wasn't getting better in any sense. Ryan saw him Thursday evening and it was hard for me to even look at the picture of this little boy.  My heart hurts for him.

Thursday - the day after an unsuccessful surgery

While all of this treatment has been going on, Ryan and I have been talking with the renal transplant team (yes, a kidney transplant for a cat) at U Penn.  This was our hope for him when we left Texas,  U Penn has one of the most successful transplant programs in the US.  This is Tyrion's only chance at an extended, normal life at this point. Many cats go on to live several years after an uncomplicated renal transplant.  While most pet owners would/could never consider this possibility, we did.  Yes, it's kind of crazy.  Yes, it's a huge financial burden.  But at this point, we are willing to do anything to save this kitten.  We made commitment to him when we adopted him from the shelter that we would care for him in sickness and in health and provide him with the best kitty life.  Did I ever think I'd have to consider getting a cat a kidney transplant?  Never.  But, for this one?  He's special.

Unique, I am.
Baffling everyone, I do.
In the meantime, we talk with veterinarians for a few hours every day, discussing what we can do to get this kitty stable enough to go on to transplant.  Ryan is still with Tyrion.  I am at home with Louis and the rest of the pets.  They miss him.  I miss him.  We want our kitten back.  We don't just want A kitten, we want Tyrion to come back.  We keep telling ourselves he can hold on.  He is a lion.  If you've ever met Tyrion in person, you know what a sweet, sweet kitty he is.  He loves and cuddles with everyone and anyone.  Our other cat Khleo, continues to search the house for him, won't go outside anymore because she doesn't have her pal.  The house just isn't right without him.

I will continue to update my blog as we get more information on Tyrion as it is difficult explaining to all of the people (we love that you all care!) what is going on with him every day.

We have set up a Go Fund Me site for Tyrion's care.  We are prepared to take on what we need to to see him through this, but any help is appreciated.  All of Tyrion's care has added up quickly, an ICU for a cat does not come without a high price, we have learned. We even told each other today, we don't care if we get wedding gifts.  We'd rather have our kitty come home. I remain hopeful that I will travel to Philadelphia in the coming weeks to get Tyrion and bring him home; healthy, and with a new lease on life. 

We should have more news, which I will share later today or tomorrow.  If nothing else, please pray for this little boy.  He sure needs a big miracle right about now. 

The link to our Go Fund Me site, if you'd like to help save our little boy is:

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