Review Fluids in abdomen

I had a very tiring time but am better now.

I brought Megat to the vet yesterday as his abdomen was even more distended and he had difficulty walking, going to the toilet and getting up on the bed. He had some difficulty breathing on Thursday night as well.

When we saw Dr Ly he immediately said that he would have to remove some of the fluids . So he had a brief consultation with the imagists and then Megat was whisked to another part of the hospital for the procedure. Dr Ly then informed me that once they have extracted as much fluid as they can, they would do another ultra sound for him to see all the organs and the pancreas as well. We didn't manage to see the pancreas last week because of the fluid.

After some time Megat came back yelling and very alert. It was good sign that he was complaining about what they had done to him and he was eager to see what else went on in a hospital. I was very glad for that.

They had extracted 450ml of fluids from his abdomen. The ultra sound was clear and there was nothing worrying in any of his organs. There was only the thickening of his intestines which Dr Ly told us about some months ago.

Dr Ly said that since there was nothing else, he suspected that Megat's lymphoma was active again as there was no cure for that. So the final decision was to continue to help him to lead a comfortable life with no chemotherapy (which was decision I made some time ago) and so the protocol remains much the same. If the fluids accumulate again, the only way is to remove it. This time they had used just the needle and not the suction as it would be easier for Megat and less traumatic. However there is still some fluid remaining as they wanted to be safe.Btw his PCV remains good at 27.

This morning I had given Megat a bath as he has been unable to take care of himself well and he was unable to go into the litter bin because of his distended abdomen. He was quiet during bath time protesting only when I had shampooed his feet. Here he is drying himself.

He even had a drink if water. I must say that this is only the third time that I had seen him drink water in many months. I think it's because I made the decision to lessen the SubQ fluids. He has not had any SubQ fluids in 2 days as I think the fluids may have contributed to the accumulation of fluids in his abdomen.

From today however I would have to give him the SubQ but only 150 ml instead of 250 ml daily. Dr Ly recommended this as he said the SubQ may have contributed to the edema. (Thanks D for drawing my attention to this possibility)

This is Megat taking a break on my bed that he climbed onto by himself. He also has a new collar. Megat seems happier as he has always been very particular about cleanliness and would demand that I clean his litter in his night cage immediately if he had pooed in it.

Here Megat is sitting on grandma's bed. He had not been here for 3 weeks which was the duration of the edema. Now he is resting well with grandma.

I am much more positive now about his condition than before. Even though Dr Ly said there was nothing to be done about the fluids I am glad we still have the option of extracting it when (not if) it happens again.

He will still be with the albumin regime that needs to be taken neat, not in his food nor with his food. Dr Ly also recommended Th17 capsules, a protocol that provides for cancer care. We will look into it as it has had good results for cancer patients.

- may all be well and be blessed -

Update

Megat will go to the vet again this evening. Yesterday, he was breathing rather quickly and of course his abdomen is even more distended now. However the surprising thing was he was able to climb onto my bed to rest although I must admit that he has been resting in his cage more and more as he has to do no climbing there.

He has been eating the albumin although not as readily as before. However, if I mix the albumin in his food for the syringe, he would eat the whole mixture quite willingly. I think there is no albumin taste then. I will have to discuss this with his vet. Also I wonder if his 250 ml daily Sub Q had contributed to the fluid as it may be too much for such a small body to take everyday as well.

We will see what the doctor says later and give an additional update.

Megat's Vet Review

Megat's PCV fell way below the mark at 14 last week (20 September, Friday) when we had gone for the PCV check from 35. Then Dr Ly saw that he had a distended abdomen and ordered an emergency ultra sound. The imagist found nothing wrong with his organs, rather there was fluid in his abdomen and this was why his abdomen was round and a little turgid. Then she had taken out 5 ml of the abdominal fluids which made Megat very unhappy for a test. She also said that if Dr Ly agrees, it would be possible to extract the fluid using just one needle as well. When he knew this, Dr Ly ordered a 2 blood tests, which means Megat needed to be poked again. He was so unhappy that he bit me to tell me so (I had helped to hold him when Dr Ly took out the blood). Dr Ly suspected either liver failure or a heart condition. 

However, when he checked Megat's heart, there was nothing to cause any concern. His blood test was also not so worrying although the indicators for his pancreas was rather high. Dr Ly said because of the fluids in his abdomen, it was a little difficult to make any diagnosis. BUT because of his PCV, Dr Ly actually contemplated a blood transfusion but finally decided on Eprex and the Blood Stimulator. It is one capsule a day and one injection of Eprex on alternate days.

Then he said we should come to see him again yesterday (Monday 23 September) to have the PCV checked again. We got the results of the fluid yesterday and we were relieved that there was no cause for concern in that fluid. His PCV has also increased from 14 to 27 (HURRAH) and now we are more able to see what else we can do to help him. I did ask Dr Ly if it was possible to extract the fluids from his abdomen but he said it would not be advisable as it would be difficult to ascertain how much fluid can be extracted. He also said that there are drugs that Megat can take but since we are not going for an aggressive protocol, this would also be out. Finally the decision was to feed Megat with 2 soft-boiled egg whites a day for the albumin and if he has increased albumin in his system we hope that the albumin would absorb the fluids back into his system.

We are very lucky that Megat ate the soft-boiled egg whites quite happily yesterday. Thanks to cat_aunty for her advice on the best way to soft-boil an egg and to D, for telling me that the Blood Stimulator might cause constipation (yes, he had constipation again). As a result, I have increased his lactulose from 2 ml to 3ml a day.

So all in all I think Megat is still comfortable. I only have to watch out for breathing difficulties or if the abdomen becomes even more distended in these 2 weeks.