Update on Ronnie James (for anyone who’s interested), or, Saving the Wrah-Wrah.

As you probably know if you’ve been reading here for a while, we’ve been treating Ronnie James, aka the Wrah-Wrah, aka le petit Wrah-Wrah, aka our furbaby, aka our son, for asthma for the last seven months. Well, a lot’s happened in that time, and some of you have been so kindly asking after him, so here’s the latest.

After his initial diagnosis of asthma, Ronnie James’ progress fell into the familiar, frustrating “one step forward, two steps back” pattern. With each step back, we’d return with him to the vet, and each time, his chest x-ray would come out looking different than the previous one. In November, his x-ray showed a collapsed and consolidated lung, conditions that are typically seen as complications of feline asthma. That was disheartening enough, but after a fairly unchanged January x-ray, he suffered further decline and another crisis, and back we went for more imaging. This was in the first week of March, and we found ourselves confronted with an x-ray that was abjectly frightening. It sent us down a rabbit hole of worry and fret. We’re just now emerging from the other side.

Ronnie James’ chest x-ray that day – it was March 4, I believe – was ghostly white, practically opaque. His chest cavity was so filled with fluid that we couldn’t see his heart, and his abdominal area looked the same. His liver was obscured. His stomach was obscured. It was alarming hearing the doctor navigate around Ronnie James’ insides as we stared at the screen. We were basically looking at a cat-body-shaped silhouette filled in with murky whiteness. We were looking at a big question mark.

“Right here is where we should see his heart,” the doctor said, pointing at a section. “Here is where his liver should be. And his stomach would be here – ” She paused as we bent closer to try to see. “This right here,” she said, tapping a small black shape, “is his lung. The black shows that there’s air in there.”

But none of his other vital organs could be seen.

Long story short, more tests were conducted, and two days later, we were relieved to find that things were okay in his abdominal cavity. But the pleural effusion issue – his chest cavity filled with fluid – had to be resolved. All signs pointed to a disease called chylothorax. We were referred to a specialist. Ronnie James needed next-level testing, and he needed to have a chest tap to drain the fatty lymphatic fluid that had no business being there. Our doctor was hesitant to perform a complete aspiration because the fluid had accumulated directly over Ronnie James’ heart.

However, the very next day, of course, was the day we were scheduled to board a plane to France for a week! One extremely long week, from the perspective of a critically ill kitty and his parents.

While we were in France, the doctor emailed with two options for veterinary specialists, animal hospital facilities with state-of-the-art equipment to tackle specific and complicated medical situations for animals, and we couldn’t do anything about it until we got back. We needed enough time and internet access to thoroughly review the two specialists online, and we had to be able to call them with questions before choosing one. I felt like it was a stupidly clichéd race against time, and it was. We’d done our online research into Ronnie James’ condition. We knew that it was critical to drain the fluids from his chest as soon as possible. The timing of the whole thing couldn’t be worse.

So all that week in France, I ran around during the day, cried at night, anxiously exchanged messages with Ronnie James’ beloved Auntie Margaret, who generously, expertly and compassionately kitty-sat and medicated Ronnie James for us, and got little to no sleep throughout. Don’t get me wrong! I still had an awesome, wonderful time and tremendous fun with everyone, but throughout it all, a part of my mind ceaselessly counted down the minutes to getting home and taking the Wrah-Wrah to the specialty hospital.

Back in Arizona, we researched the two facilities, made our phone calls and scheduled Ronnie James for an appointment with the internal medicine specialist at the hospital we chose. We took their earliest available slot, which was for Monday the following week (yesterday). I was beside myself. We’d already waited a week, and now we had to wait another whole week! But THANKFULLY on Wednesday night last week, the clinic called to tell us there’d been a cancellation for the next day, so we were able to get him in on Thursday.

Ronnie James at the specialty hospital, pre-thoracentesis and extensive testing.

Ronnie James at the specialty hospital, pre-thoracentesis and extensive testing.

We were grateful and beyond relieved that with their imaging equipment and many years of experience, the specialists were able to perform a complete thoracentesis on Ronnie James, safely aspirating 120 ml (the equivalent of three large syringes!) of milky-white fluid, chyle, from his chest cavity. Chylothorax was confirmed.

Post-thoracentesis, resting.

Post-thoracentesis, resting.

120 ml of chyle (~1/2 cup!) was removed from the Wrah-Wrah's little chest cavity!

120 ml of chyle (~1/2 cup!) was removed from the Wrah-Wrah’s little chest cavity!

Alleviating the Wrah-Wrah of his pleural effusion was one thing. The remaining critical task was to determine the underlying cause of the chylothorax, if there was one. (50% of chylothorax cases are idiopathic, meaning that there’s no known cause.) We had to get to the root of the problem so we could take some action to prevent his chest from filling up with fluid again! Thursday evening, the internist showed us Ronnie James’ CT scan. Contrast revealed a suspicious 2cm x 1cm mass in his left lung lobe. It was also confirmed that his right lung lobe had collapsed. A biopsy from the mass and more fluid samples were sent out to an external lab for analyses and cultures.

The results wouldn’t be back until Monday, so we settled in to wait again. It was a long wait. As some of you can (unfortunately) attest, the longest wait of all is the one between the words “we found a mass” and the receipt of the lab results.

Meanwhile, we spent the weekend marveling at the Wrah-Wrah’s restored vitality since his chest tap. He was back to his old self! He was alert, active, awake more than asleep; he was talking (wrah-wrah wrah wrah WRAH! Wrahhhhhh!), playing, flirting with us and running around, throwing himself on the floor and rolling over for belly rubs, purring furiously (as if to make up for all the purrs lost during his illness), engaging in his favorite games and raising hell with Nounours again. We hadn’t seen him like that in months! Without the fatty lymphatic fluid crowding everything in his pleural cavity, Ronnie James’ lungs could expand normally again. He was getting more oxygen, and it showed. The difference was dramatic.

Ronnie James returning to his former self over the weekend.

Ronnie James returning to his former self over the weekend.

Late Sunday afternoon, we received a wondrous surprise phone call from a doctor who was working with our internist. She reported that Ronnie James’ labs had come back free of cancer and infection!

This brings us to today. At some point today, the internist will call to report the details of the lab findings – one of the cultures is still pending – and to go over a game plan for the next steps. Part Two of the restoration of the Wrah-Wrah’s pulmonary health will begin soon, and with luck, it’ll be uneventful maintenance from there on out!

We’re hopeful that we can find a way to resolve this for him so he can live out his lifespan with a high quality of life. He’s only 10… he has at least 10 more years to go!

Thank you all for your kindness and support. We feel the love, and so does Ronnie James. We feel blessed, too, to have a wonderful, caring team of doctors between the University Animal Hospital and the VCA Specialty Animal Hospital. They saved Ronnie James’ life, and we can’t say enough how grateful we are to have this precious little guy with us, being his old self!

There aren't enough kisses in the world for the Wrah-Wrah....

There aren’t enough kisses in the world for the Wrah-Wrah….

Thank you all for reading! Please pass this post along to any kitty or doggie parents you may know who might be going through the same or similar medical crises with their furbabies. It would be wonderful if Ronnie James could provide with a little information and hope.

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