Finally

His picture and his nature was the same - he was beautiful to look at and wonderful in his goofiness

We got his ashes last Saturday. It came in this small jar decorated quite simply - just like Totoro when he as alive- a simple sweet kitty.

 

The kitties gathered around as it was some time ago that we were so busy at night. They sat around this space waiting for what was going to happen. We have become a rather quiet household, not because Toro was a noisy kitty. He was quiet and preferred his own company and ours of course. I think we are just trying to figure out our spaces again without him. But Bujang missed him most of all as he has not stopped looking for Toro in all of our rooms specially at night or at dinner.

We buried him here, in this 7 year old jasmine plant. Toro liked the smell that it gives off in the evenings. He would sniff the air whenever the jasmine flowered.

Totoro - 1st Mar 2005- 16 Sept 2012

Toro and I have the same birthday :) We would be celebrating his life for some time yet:)

Totoro on Tuesday and an Update

Who is that san? I don't recognise the scent...



Toro's older pictures. Sorry I have not taken anything new of him but will try today.

Last night he spent much of the time trying to get comfortable in bed and found a spot close to the wall, on my blanket. We did not have the air con on as the vet techs told me that anemic cats get cold because of the anemia and so we had just the fan.

Bujang and Tanaka did not sleep on the bed as they spent the whole time last night sniffing him and trying to get to know him again. Even Megat came close to sniff him. Toro took it all in good grace and touched noses with everyone except Megat.

This morning he had 10 ml of the rice/fish/veg broth concoction and all of his pills. He went up the coffee table to drink from the public water bowl and gave me one loud meow for a grooming session. Then he decided some rest and hide was in order and hid at the green tunnel. He did go to pee several times.

Later I will try to get him some steamed fish for dinner. Maybe he would get his appetite back.

Today, we would be going to Tampines to get his pcv reading as well.

UPDATE

Our new photos of Totoro

 Toro and Bujang resting easy ...

 Toro pretending that the camera wasn't there. His right eye is smaller than his left but this could be due to him not being well...

His pcv remains stable at 20% when we took the test this evening at Tampines. Dr Tay said that this is on the low side of the indicator, the lowest being 24%. However he said that this was good progress and that when there is a transfusion, it is not good to have such a high indicator right after. We are hoping that his Eprex would do the trick. Tomorrow he gets his last of 3 injections of Eprex. However I remembered Megat had more than that when his pcv was very low 31/2 years ago, sometimes as low as  5% only!

He had his sub q and pills given to him at the clinic. Dr Tay also gave him something for his vomitting as today he had vomitted twice. He was not pleased at this and swatted him. WOAH! But Dr Tay was very understanding and said that Toro has always been such a good boy and probably today, it was one injection too many. He had 3!

At dinner, he refused to eat his steamed fish at 6 pm and I could not get the fish fine enough to go into a syringe. However I had the presence of mind to buy a sachet of Walthams renal pouches. So I had put some through a sieve and given him this to eat through the syringe. He had 15 ml before he refused any more. So at least that was some food in him.

Before I put him to bed (and he is now in bed on my blanket with the fan on), I had given him 15 ml more of the same and he ate quite willingly. He is quite used to being fed with the syringe as we give him a mixture of pumpkin and papaya every day to help with his digestive system.

He drank quite a lot of water and had gone to pee twice when I am home. However during the day, it was difficult to see as there are 4 cats using the bins and I did not want to separate him from the rest. It seemed that he was busy walking about the whole day and had climbed up and down his cat tree by the window. Grandma and Sister N were very worried that he would unravel his stitches. Even Dr Tay told him not to be climbing up and down. But he checked the stitches anyway and announced them secure. 

I hope tomorrow he would decided to eat something by himself but if not I would just need to feed him with a syringe until he is stronger. 

We have a review tomorrow with Dr Ly at 6.15. Please wish us luck.

Update for Totoro

an old pic of Toro

Toro had 70 ml of Type A blood from Bujang. He was all wrapped up in a rowel when I saw him, sitting quietly when a nurse gave him his blood transfusion. He was cold as he was also anemic due to the operation on Saturday.

I saw Dr Ly and he told me that when during surgery he saw that his left kidney was not working at all due to the amount of sand in it. His right kidney was misshapen and swollen and when he cut it, the urine spurted out of it. This kidney was also almost blocked by sand. There was no big stone already as the 2 big calculi has dissolved into sand and he had to siphon all of that out. Of course as a result of the cut, he has anemia as well and his urea and creatinine levels are way up. Dr Ly said that without the surgery, he would only have about 3 weeks before his kidney totally shut down.

Now that the had gotten rid of the sand, he could now urinate better and he was pleased with that. However, because Toro was so stressed in hospital, he was not getting any better so he wanted me to bring him home to see if home would be better. Dr Ly said this would be his recommendation always but he wanted to monitor Toro in hospital and that was why he had to stay.

He also added that he did not know where the sand came from (and of course this was what had puzzled all his doctors from 2 years ago as well). He said all that we could do now is monitor his urea and creatinine and he has to get sub q 250 daily. he would also be given some meds for his anemia. he has to take his usual kidney medicine and we have to come back in 2 days.

When I left him in hospital, he was asleep and so I hope that Dr Ly is right - that home would be better for him. (He did perk up a little when he heard Bujang wailing in the hospital). I hope his PCV is better but I will only know this tonight.

UPDATE:
Toro's pcv is now up to 20% from 10%, thanks to Bujang. But it sems sometimes it would take much longer to get a true reading so tomorrow we are going to Tampines to get his pcv reading. His review with Dr Ly is on Wednesday.

He came home at 7.40 and immediately inspected the house. Then he hid in the tunnel but he actually allowed himself to be syringe-fed with the mixture that Katie had shared with us, but only about 5 ml of it before he decided that enough is enough. he drank some water by himself (HOORAY!) and is now in bed, sitting on my blanket.

He has eprex for anemia and a herbal remedy to increase his blood pcv as well. Of course he came home with painkillers and anti-biotics. It is lucky that he is also quite easy to pill.

Vet Verdict for Totoro

Totoro's vet visit was a mixture of good and not so good. The blood test was good apart from the 2.5 indiactor for creatinine. He is well-hydrated and his PCV is 35.5 5. The US was good and bad. His left kidney is stable but his right kidney has more stones although it is less dilated than before (4.6 compared to the previous 5.6). Dr S said that the dilation was the more major thing to look out for and as his kidney is less dilated now, that is a cause for celebration. The really good news is that all his other organs are fine and his bladder is clear of sand and his urethra is also clear. However, 2 of his kidney stones have increased from 5 mm to 6 mm! Dr S was very positive and she said he is ok and if nothing else happens (like blood in his urine) he should be back for a review in 6 months.
Dr Ly was pleased that he is stable and gave him an additional pill - a Urinary Acidifier to try to dissolve his crystals as we do not know for sure if his crystals are struvite or oxalate. He said it would not impact his kidneys in any way but it may allow us some conclusions. We have to come back in 2 months for an US to see if the crystals have dissolved. If not, then at least we know they're not struvite crystals and take it from there. I am willing to try this as the pill is very small and we could go forward from here.

Lysimachia No More!

I decided to take him off the shilintong or lysimachia as he vomits every time I give it to him. The shilintong is for his crystals or at least it promises to break up his crystals. This morning he vomitted twice, only liquids, so its time for a rest.

Good News at the vet for Toro

This morning I went to the vet. I knew it cos san did not let me eat eventhough I kissed her in the morning so that she would wake up. I was furry hungry and she locked me up!

Then I saw the 2 carriers in front offur the cage. I know Tanaka and Bujang would not be going as they were too curious and they gotted to eat. It must be me and Megat, although Megat gotted to eat too. No fair!

Here I am shaven. All my nice fur gone! BUT san said Dr P gave her some good news for me so I will tell it all here.

Dr P said that one of my 6 mm crystals is now 4 mm and one of the 5.3 crystals is now 2 mm and she said the other smaller crystals are stable. This means they have not grown smaller nor bigger!! HURRAH! HURRAH! But the bad news is my 8.8 mm crystal is now 8.9!! My kidneys are now no longer swollen and I am not in danger of going into surgery like I was 3 months ago! More HURRAHS for us. We now have to see Dr P in 6 months and not every 3 months like before! Dr P said that this was what she had hoped for and san was to continue doing what she did with my medicines. That is the yukky bit cos I do NOT like medicines!

This is me every evening when I have to eat meds. san says she should tell everyone what she did so maybe it would help another kitty. san says she is not sure now if I have oxalate crystals as she thought these crystals could not be dissolved. Dr P told her 3 months ago that I had oxalate crystals although our test was not conclusive. san did the test 3 times with my help but there were only grains of sand and no one was able to tell us anything clearly.

This is what I have to take everyday although the Sub Q is only 3 times a week. I am on sodium chloride 0.9%. Cousin R always helps san with the Sub Q though. I have the following from the vet at arvc:

1 capsule of Nature's Sunshine Kidney Activator
1 capsule of Azodyl
1/2 tablet Fortekor
1/4 tablet (2 times a day) Alutab
1 capsule Nature's Sunshine Cranberry and Bucchu for my UTI
(when I ate only this, my crystals were stable)

Then san went to the internet and boughted the following from Pet's Alive because she is a little desperate to make me better:

4 drops of Kidney Support twice a day
1 capsule Immunity and Liver Support
3 drops of Runipoo Relief for my digestive system
A few granules of UTI Free in my breakfast and dinner

From the pet store:
1 capsule of BURP Omega 3 (she used to give me 1/2 teaspoon of Omega 3 from Probiotics Salmon Oil but decided on the capsule as was easier to give me)

I take all these 7 days a week with no off days! san gives me some sieved pumpkin and papaya as a reward for each capsule that I take. Also the pumpkin keeps me regular :) So you can see why I do not like the meds much as I have to take a lot. san is now contemplating shilintong to allow my crystals to pass out of me but she will blog about that when she gets it this Friday. She tells me she will try to get it in Chinatown. I have yet to approve of this!!

All that thinking about my meds have made me sleepy. san says she will blog about Megat tomorrow....zzzz....
PS: san says she will put this on my sidebar so it would be easier for others to see and of cos sometimes san needs to refer to the list to make changes if there is any need to although now Dr P said she should just follow this regimen closely for now.

US Results

Dr P was not about but Dr T was so I requested that Dr T spoke with us about the US results. It seemed that his renal pelvic cavity is not more enlarged which means there is no blockage in his right kidney. However the stones have not decreased in size (only the stones in his right kidneys have become slightly smaller but not the ones in the left kidney). She noted that it is more compatible with calcium oxalate stones. Dr T said there was nothing we could do with these type of stones but rec that we go on with the urinary diet.

We would just have to monitor his condition and he has another US in 6 weeks.

Hospital Oh No!

Not again!

Toro will be going to hospital this evening for his ultra sound tomorrow. Since the ultra sound can only be done in the morning, I have to send him this evening so he has to stay overnight for the test. The ultra sound is to see the state of his kidneys as his last ultra sound saw that both his right kidney and his right pelvic cavity were swollen. He also has a urinary catheter to allow him to pee 2 weeks ago. Also I hope the vet Dr P would be able to discern the type of uroliths he has. So many tests for a little kitty!

Toro's Vet Visit

We were the first one in the hospital. So Toro had a good rest.
Toro: I can see effurything! Don't think I don't know what will happen san!
I remember this place!

I was glad Toro was very curious about everything that was happening.

After his ultra sound of his abdomen and throat, the injection for his urine sample, his blood test and his sub q. He was still very alert and good-humoured.

One of the asistants asked if she could take his picture. Toro obliged of course.

The blood test for 13/11/10

The numbers were not bad but not so good either esp for his calcium and creatinine.

Today's blood test was more encouraging. Hurray!

BUN, creatinine and calcium numbers were ALL much better. :))

His new diet.

The hero at home in shorn glory.

Oohhh...I am do tired~~~ zzzz

His ultra sound showed no dark shdows or tumours which was excellent. BUT Dr P was very concerned as his right kidney was much bigger than his left and there was a crystal or urolith that was partially blocking his urethra. As a result his right pelvic canal was swollen. Dr T had told me that this was a possibity and this condition is dangerous as he would need surgery if the crystal does not dissolve.

His right parathyroid was also a little bigger than his left one. Dr P said it was better to take the ultra sound of the thyroids as even when the iPTH is negligeable, it would be better to see the size and condition of the parathyroids themselves. So she shaved his throat. Poor thing Toro. But he was very good about it and behaved very well. Dr said she was not worried about the parathyroids and the enlarged one was within the norms.

Dr P tried to test his urine to see if she could determine if the crystals were struvite or oxalate calcium but it was not successful as there was only sand in the bladder. But she advised me to give him a new diet for his urinary tract. She said if its struvite, the diet would take care of it. f its oxalate calcium then the diet is of not much help.

We would need to come back in one month as Dr P was concerned about the enlarged pelvic cavity and the swollen kidney. She did say that it would take about 3 months to dissolve the crystals. Her final opinion is that the high calcium indicator was the secondary result of his kidney failure.

On the positive side, Toro really likes the new diet :)