I hope you aren't waiting for a reply here before getting your cat to the vet's. She needs to be seen if she has stopped eating and drinking. The weight loss from 6 to 4 lbs in 5 months is scary ... that's a third of her body weight! That's equivalent of a human going from 150lbs to 100lbs in 5 months. Did your vet check her thyroid (T4 test) at the last blood test? Hyperthyroidism can be a cause of rapid weight loss (usually accompanied by a GOOD appetite, but not always). It is quite common in older cats (average age of onset is 13 yrs old).
Did your vet give you any pain medication (like buprenorphine) for after the surgery, for a few days? She may not want to eat if she has pain. The vet, likely, gave some pain medication at the conclusion of the dental, which may have made it easy for her to eat when she first came home. But if that pain medication wore off and she has pain and no more medication, that could account for her not eating.
With a creatinine of 3.1, she is at a low stage-3 CKD (Chronic Kidney Disease, the term now preferred by veterinary kidney specialists for "CRF") and shouldn't be a major concern if it is stable and the phosphorus is normal. You can learn more about the stages of CKD on the IRIS website (International Renal Interest Society) at: http://iris-kidney.com/guidelines/staging.shtml But it's very important for cats with CKD to be well hydrated, so if she isn't drinking much, you need to try to get some water into her. Another reason to see the vet.
At her age, there can be many possible conditions that can cause her not to be eating. No one can diagnose her (even the vets) via the internet and she needs to be seen by a veterinarian. With the huge weight loss, it's important to find out what is going on, soon.
Wow! 20 years is old for most dogs. What breed is he? I live in the US and am not up on UK requirements. I know/think that England is rabies-free and doesn't require rabies vaccination. Does Ireland have rabies and require vaccination?
In the States, what to do about rabies vaccinations always comes down to what the state/local laws require. If Ireland requires rabies vaccination and you want to move there ... you need to contact the authorities in Ireland and see if they might give a "waiver" for the vaccination requirement in light of your dog's age. In the US, some states allow waivers, and some don't ... though I think the states that allow waivers do it only for health issues, not age.
Which brings up the question of what your dog's health is like. Vaccines are only intended for "healthy" animals, so if there is a serious health problem, it could either increase the risk of a negative event after vaccination ... or, simply not produce immunity.
Has your dog had any other type of vaccination in his life? If so, did he have any negative reactions to any of them? That might give you an idea of how he might respond to a rabies vaccination.
In general, if your dog is healthy, a rabies vaccine should not be a problem (personally, I'd avoid the Boehringer Ingelheim "Fort Dodge Rabvac" rabies vaccine, which has a history of adverse reactions, though the company claims to have cleaned up the vaccine). Avoid giving more than one vaccine at the office visit ... and if vaccinations for other diseases are needed, give them AT LEAST two weeks before or two weeks after the rabies. Studies have shown that the greater the number of vaccines given at an office visit, the greater the risk of post vaccination reactions (a study by Dr Philip Kass of UC Davis about 10-12 years ago). That is particularly true of small breed dogs (in which the adult weight is about 20lbs or less).
If your dog is healthy and doesn't have a history of post vaccination reactions ... it is probably safe to vaccinate him. But there are never any guarantees when it comes to vaccinations. With a dog that old, I'd first check the law in Ireland to see if it is required and/or if they will allow a waiver. Since you live in the UK (England?) which is rabies-free ... I would think your dog has an extremely low risk of bringing rabies into Ireland.
I'm not a vet ... but even vets can't diagnose over the internet. At most they can suggest some possibilities. But vomiting is one of the most common signs of disease in cats ... and can be caused by MANY things.
Vomiting is not normal for cats. And when a cat is vomiting repeatedly ... like your description of multiple times a day ... you really need to take the cat to a vet. It requires a physical exam and diagnostic testing to determine what the problem is.
It could be something minor like a food allergy ... or something much more serious such as kidney disease or pancreatitis ... or cancer. It might be caused by a blockage from ingesting (eating) a foreign object, etc.
The swollen eye could be from an allergy, or bug bite, or a viral infection (e.g. herpesvirus) or bacterial infection. Again, a vet needs to examine it and, if necessary, do diagnostic tests. Whether it is related to the vomiting or not, I don't know. Usually upper respiratory/ocular issues are a separate system ... but there is much I don't know. Herpes is most common in cats and can be treated (but nothing will cure it) with an antiviral, like famciclovir (brand name, Famvir).
Being "tired" may be a sign that she has some pain and/or anemic. Another reason that she needs to see a vet.
I would anticipate that a vet, after a general physical exam, would want to do some blood work to check her kidney and liver function, make sure she isn't anemic, etc. I'd guess that a vet would also want to check for pancreatitis ... which doesn't usually cause excessive vomiting in cats as it does in dogs, but some cats do vomit a lot with it. But if she is still eating well (i.e. no nausea) perhaps that suggests the problem is something else. Anyway, there is a basic in-clinic blood test for pancreatitis now, though a more specific lab test for pancreatitis may be done if the in-clinic test indicates that pancreatitis is likely.
Good luck and I hope you can take her to a vet for a proper exam and diagnosis.
If you want to train your cat to use the toilet, just google it. There are numerous YouTube videos and websites that explain the process. You need to start with getting a "kit" that consists of special litter trays that attach to the toilet ... starting with a solid tray and then switching to trays that have holes in the center, gradually getting larger. Amazon has some of the kits for sale, as well as other dedicated websites.
That said ... I can't say that I'm a fan of toilet training cats. It goes against their natural instinct to dig a hole, go, and then cover it up. So, you are trying to get them to do something that doesn't come naturally. There are a number of other concerns as well, including the trauma of a cat falling in (toilet seats are very slippery), missing early signs of illness (e.g. frequent peeing and/or volume of urine), etc. Here is a website that I saw by a cat behaviorist that gives some of the reasons for re-considering training a cat to use a toilet: http://www.catbehaviorassociates.com/toilet-training/
It is your choice to try if you want, and some cats seem to take to it. If you are talking about the 8 week old kitten that you have been concerned about breast feeding ... I'd wait until she is older and larger. I would think that a young kitten would fall in easily and could be very traumatized. Any cat is likely to have a lot of stress when trying to get it to do something contrary to its natural instinct. Personally, I've never minded scooping a litterbox 1-2 times a day. It takes only a minute or two to keep the litterboxes clean (rule of thumb is to have at least one more litter box than you have cats ... e.g. 2 boxes for 1 cat, 3 boxes for 2 cats, etc).
I don't know of any studies that have been done to look at the effects of giving human milk to an 8 week old kitten. Generally, milk is intended to be species-specific. Milk is enriched with nutrients and antibodies for a specific species. That's not to say that it can't be given to another species at times ... many humans drink cow's milk regularly (at any age). But it's not necessarily the best thing.
For kittens, who (in contrast to humans and many species) do not get many antibodies (almost none) while in the uterus ... the critical time is the first 24 hours after birth. The kitten's mother produces a special milk ("colostrum") that is rich in antibodies that will help protect the kitten against disease until it's own immune system is mature enough to produce its own. After about 24 hours, the kitten's intestines are no longer able to allow the large antibodies to pass through it and into the bloodstream. There are still antibodies in the queen's milk after the 1st 24 hours, but they just get passed out and may only help a bit within the intestines, but not systemically.
My point here is that the best milk for a kitten is milk that comes from a cat. It has nutrients and antibodies that are specific to a cat's needs. Human milk may not hurt, but it won't give the kitten everything it needs.
While some cats are lactose intolerant (as are some humans) ... not all cats are. But it doesn't hurt to use lactose-free milk if you want to give some milk. I'm not a breeder, but I'm friends with many ... and am a member of a feline health list that is focused on breeder issues. Many will use KMR (Kitten Milk Replacer) for young kittens, which you should be able to get at a pet store. Others like to use goat's milk which most kittens seem to tolerate well.
If the kitten was weaned too early ... a desire to suckle is quite common. Many will get the kitten a stuffed toy for the kitten to suck on (with no parts that the kitten might chew off and swallow, which could cause a blockage). It is usually just a phase that they will eventually grow out of.
By 2 months of age, the kitten should be eating solid food. That doesn't mean that they won't continue nursing on their mother for a while, if the queen allows it (some do, some don't). At that point, the nursing is not for nourishment which they get from solid food, but is more of a comfort and being close to their mother. Many of the breeders I know will allow kittens to nurse (if the queen allows it) until they leave for their new homes at 12-16 weeks of age.
Either way, by 2 months, the kitten shouldn't "need" to nurse and should be eating solid food. I don't think giving milk is abuse ... it just isn't necessary. It may or may not cause diarrhea. Actually, many breeders find that the transition from milk to solid food seems to cause diarrhea in some kittens. It can take their gut a little while to adjust. It seems that some kittens do better when weaning to canned food ... and some kittens do better with dry food. In general, I feel canned food is better ... with more water content and higher protein (and lower carbs), so I'd try that first ... using a good pate-type food, rather than the "chunks & gravy" type foods. The pates tend to be higher in protein.
I'd suggest transitioning her to solid food now. Get her a toy that she can suck on if she still has that reflex because of early weaning. And you can hold, pet and comfort her to give her the emotional support she needs.
I'd probably first talk to your vet to see why the charges have changed so much and if your vet may offer you some options that might reduce your costs. Most vets understand the financial challenges and will work with you to find a way to give good care and still lower costs.
But if it continues to be high ... and if you live in an area with other vets ... you can always check with other clinics to see if the charges are less. But also be aware that lower costs may involve less monitoring or other changes that might increase the risk of complications. You just need to decide how much risk you are willing to take. Most surgeries don't need "all" of the bells and whistles, so I would think that there are some compromises that can be made that would still give your dog good care. If all the clinics in your area say that they would charge about the same as your current veterinarian ... that will let you know that your vet's prices are about the norm.
Personally, I prefer to use private practices ... owned by the vet(s) that work there ... in contrast to the big chain, corporate-owned clinics and hospitals. I haven't tried to compare costs between the two, but I've been concerned that corporate administrations may be more interested in profits than what is best for the patient. That may just be my own personal hangup without any facts to back it up ... but I still like to support the vets who struggle to own their own clinics and have to compete against the big corporations. You might check to see if your clinic has gone through a change in ownership that might account for some of the changes in the fees. Good luck.View Thread
As a client, I think you certainly have the right to ask questions about charges and procedures. Probably more important is the WAY that you ask the questions. If you ask when you are angry or become antagonistic or confrontational ... your vet may get defensive and the conversation could be unpleasant. But if you ask with a sincere desire to know why costs are higher and why there are new charges compared to two years ago, your vet will, likely, be happy to answer and let you know what your options are.
There may be a number of reasons for the increased costs. Sometimes the cost of medications that the vet normally uses goes up for them ... i.e. what the vet has to pay to get them. Occasionally, medications that they normally use (e.g. for the anesthesia protocol which requires several different drugs) are no longer available for various reasons (often a production problem by the pharmaceutical company) ... which forces the vet to use a different medication that may be higher in cost.
The IV charge is understandable ... and is very good veterinary practice. Giving fluids during a surgery can reduce the chances of dehydration or low blood volume and low blood pressure. Having an IV allows a vet to easily add a medication, like a pain medication. Most importantly, if something goes wrong in surgery, having an IV in allows the vet to quickly administer needed medications, which can mean the difference between life and death. That said, not all vets use an IV, particularly for short surgeries. It is your decision how much risk you are willing to take in a surgery. Using an IV is certainly ideal in terms of good care, but if you are willing to take the risks associated with not having it, that is your call.
Other things that can make a surgery add up quickly are other options that are intended to increase the safety of the surgery ... especially with monitoring (e.g. blood pressure, oxygenation, temperature, heart rate, etc ... just like in human surgery). Also important is post surgery care, e.g. a warming blanket since low body temperature is common (and can be dangerous) or post-surgery pain medications.
Another cost is often for pre-surgery blood work. That can be important as a means of identifying other health issues that may complicate matters or cause a change in choice of medications, etc. Without pre-op blood work, the vet may have complications that might have been avoided.
I think it is fine to ask questions ... as long as it is done nicely and with respect. If your new vet is young ... not long out of vet school ... then he/she may just be trying to do the "top-of-the-line" medical practice. But a good vet will explain the charges and let you know other options based on the amount of risk you are willing to take. If your dog's cyst is just under the skin with no involvement of internal organs, etc ... then you may want to do without some of the bells and whistles. But if the cyst is in a tricky spot for removal, you may want to have some of the bells and whistles ... if you can afford it.
I'm not a vet, but one of the co-authors of the AAHA Canine Vaccination Guidelines (the newest 2011 update and all previous versions), Dr Richard Ford, is my mentor and good friend. I've not only attended a number of his talks at vet conferences, but have spent many hours talking about it with him. He feels I have a good grasp of the issues (though he's not responsible for anything I might get wrong). Dr Ford is emeritus at NC State Univ (boarded in internal medicine and a specialist in infectious diseases of the dog and cat). He is also a co-author of the AAFP Feline Vaccination Guidelines.
Your frustration is understandable ... but let me share a few things that might help.
First, the AAHA (or AAFP) Guidelines are just that ... guidelines. Dr Ford always emphasizes that they are not "protocols" that must be followed. They are intended to give information and recommendations so that vets can develop the protocol for their area and individual patients. Vets are not bound by them.
When determining a vaccination protocol, a vet should modify it for each individual dog/cat based on that pet's age, health and life style ... i.e. risk of exposure to the diseases that there are vaccines for. Dogs that come into frequent contact with other dogs of unknown vaccination status, or in places of large groups (e.g. shelters, boarding kennels, etc) may benefit from more frequent vaccinations ... whereas dogs that are mostly indoors at home with few other dogs, etc are less likely to need annual vaccination.
While the usual "core" vaccines are: distemper, adenovirus-2 and parvovirus ... in some areas of the country, "core" may also include lyme disease and/or leptospirosis (which DO require annual boosters) if they are endemic in the area. The point is ... there is no "one protocol" for all dogs, and vaccines (and frequency of vaccinations) need to be tailored for each dog based on risk of exposure.
While Dr Ford and the other co-authors of the Guidelines have long encouraged, for most dogs, boosters every 3 years for the core vaccines (DA2P) ... and, actually, the newest Guidelines now say "no more often than every 3 years", so longer intervals are also possible since some of the vaccines have "duration of immunity" studies for 5-7 years ... but it is only a "recommendation", not a requirement. Dr Ford acknowledges that vets may still give annual vaccinations and be within the "standard of care". He doesn't encourage annual boosters, but vets have the right to decide the booster interval.
Some vets still feel that there are owners who will only come to the vet for vaccinations ... so, they use them as the "hook" to get pets in for an annual wellness exam. Dr Ford sometimes suggests that vets tell clients to come for annual vaccination boosters ... but then only give the vaccinations if they are needed (e.g. every 3 or more years). Certainly, vaccinations help the income of some vets, but the opportunity for an annual wellness exam is the motivation for many to recommend annual boosters. It can help if we assure the vets that we will be in at least once a year, with or without vaccinations.
Vaccines are safe for the vast majority of dogs. But they are biological products and some negative reactions may occur. The risk of more severe reactions seems to be greatest for small dogs (adult weight of 20 lbs or less) who receive multiple vaccinations at the same time. Giving non-core vaccines at least 2 weeks after core vaccinations may reduce the risk.
Vaccine associated sarcomas are considered very rare in dogs ... and primarily a problem for cats. In cats, the inciting factor is inflammation which is greatly increased by adjuvanted (killed virus) vaccines. Sorry your dog had one.
If your vet insists on annual boosters, the best thing you can do is look around for another vet who is willing to booster every 3 or more years.
Your reply is a bit confusing in that your first sentence says that you canNOT agree that there is a link between your dog's kennel cough and your reaction ... but then you seem to spend the rest of the post saying that you feel there IS a connection.
Showing "cause and effect" is always a great challenge in "evidence based medicine". The only way to know for sure would be for your doctor to do a culture after you get sick soon after your dog's vaccination ... and see if they culture Bordetella bronchiseptica (a common cause of "kennel cough").
You do say that you have severe CFS/ME. I don't know all abbreviations and generally encourage people to spell them out one time. I am guessing from context that "CFS" is Chronic Fatigue Syndrome. I don't know what ME is. But if either of them (or something else) indicates that you have a compromised immune system ... then the possibility exists that you may be getting infected from the vaccine strain. All intranasal vaccines are "live" vaccines that replicate but have been modified so that they do not cause disease in the dog. But if you have a compromised immune system, it is possible that it could make you sick ... though only a culture (or PCR if there is one) could determine if that is the case with you.
My first question is ... why is your dog being vaccinated for Bordetella bronchiseptica (and/or parainfluenza) annually? They are "non-core" vaccines that are only recommended for dogs that are at a high risk of exposure. Is your dog kenneled regularly where it is required?
If your dog really needs the vaccine, you have a couple options. One is to use the injectable vaccine which is killed (inactivated). I was just talking to my friend/mentor, Dr Ford, about this a couple days ago. If I remember correctly, I think Zoetis (formerly called Pfizer) makes the only injectable (killed) Bordetella vaccine ... called "Bronchicine CAe". Since the Bordetella in the vaccine is dead, it does not replicate and cannot infect you ... and it is not given in the nose, so it cannot be sneezed out.
The drawback to the use of the injected Bordetella vaccine is that most of the experts do not feel it is as protective for the dog as the intranasal vaccines since the intranasals give a better local immunity in the nasal area. They generally recommend using the intranasal (IN) but if there is a reason it can't be used (e.g. uncooperative dogs that might take off the hand of the vet), then they say that the injected vaccine can be used. Perhaps, your situation would also be a reason for using the injected vaccine.
Also, there is a common viral cause of "kennel cough" called Canine Parainfluenza (CPIV). The injected Bordetella doesn't contain it ... (while most, if not all, the intranasal vaccines contain both Bordetella and CPIV). So, you may want your vet to also use a core vaccine (for Distemper, Adenovirus-2, Parvovirus) that ALSO has a modified live CPIV vaccine. So that your dog is covered for both Bordetella and CPIV.
The only other option that I can think of is for you to avoid ALL contact with your dog after vaccination for a while. I'm not sure how long shedding may last ... maybe a week or two?
I'm not a vet and I only make the above suggestions based on the 2011 AAHA Canine Vaccination Guidelines ... and anything I may have learned from Dr Ford who is one of the co-authors of those Guidelines.
Try not to panic over the suggestion that this could kill your cat within a day or two. While the inability to pee can quickly become life threatening for MALE cats ... it is "possible" but quite rare for a complete urinary blockage to happen in female cats, because they have a wider urethra than males.
In cats under 10 yrs of age, the most common problem is Feline Indiopathic (or Interstitial) Cystitis ("FIC") ... i.e. an inflammation of the bladder. That is NOT a bacterial infection, so antibiotics do not treat it. In older cats, like yours, it is more likely to be a bacterial infection, particularly if she has other health issues that cause a dilute urine (e.g. chronic kidney disease, diabetes, hyperthyroidism, etc). Without a vet check, there is no way of knowing.
There are also other possibilities that a vet would rule out by examination or an x-ray (or ultrasound) ... such as bladder stones (that is different than "crystals" which are generally not a factor) or a tumor, etc. The only way to confirm a bacterial infection is for a vet to take a sterile urine sample (by using a needle to extract it directly from the bladder ... sounds bad but most cats are not bothered by it at all) and then sending it out for a culture and sensitivity test.
If the problem is continuing, 2 days after your original post, I'd also encourage you to see if you have friends or family members who would help pay for a vet visit ... or ask your vet for suggestions of alternate payment plans.
Without a vet check, you can't rule out the other possibilities ... but I can give you a little info on FIC since it is common in younger cats and is something you can do something about. I've recently been corresponding with Dr Dennis Chew who is one of the top veterinary nephrology/urology specialists. He is now emeritus at The Ohio State University, though still very active in giving continuing education lectures, etc. He, along with his colleague at Ohio State (Dr Tony Buffington) is a leading expert in FIC.
What are your cat's symptoms? Is she straining for a long time in the litterbox? Is she attempting to go elsewhere (very common with cats when they have pain ... and they associate the pain with location, i.e. the litterbox, so they try elsewhere). Is she producing any drops? Have you noticed any blood? Bleeding is a common sign of FIC.
Most cats that are prone to FIC will have episodes that last for 5-7 days (my own cat had one that took a couple weeks to get over). Since it is not a bacterial infection, they usually get over it on their own. However, it is VERY painful, so giving pain medication can be important (buprenorphine/Buprenex is commonly given).
The main point that Dr Chew and Dr Buffington make on FIC is that they feel the bladder inflammation is just one sign of a problem that is really neurological ... and more specifically, caused by an inappropriate response to STRESS. They call it Pandora Syndrome.
Cats with FIC/Pandora Syndrome appear to have smaller than normal adrenal glands. Stress causes an activation of the sympathetic nervous system ("SNS", which causes the "fight or flight" response) which produces a hormone called norepinephrine. In normal cats, the response to stress both activates and then turns off the SNS. But FIC cats have trouble turning off the SNS after stress. The norepinephrine causes changes to the bladder wall that allows urine to get into the bladder wall and cause inflammation.
Relieving stress is key to controlling FIC (which includes your own stress which cats pick up on easily). Dr Buffington has a website dedicated to environmental enrichment at: http://indoorpet.osu.edu/ I highly recommend it.
Increasing water intake is very beneficial ... IF your cat is not currently blocked. A vet can easily palpate the bladder and feel whether it is full or not. Feeding any canned food with added water is best, if possible.
Hope that helps ... and that you can get to a vet soon.