Callaghan and Ronnie James, bonding (instagram series)

Just over a year ago, I took a picture of Callaghan and the Wrah-Wrah together in a companionable moment, and I instagrammed it with a b&w filter. I shared it on Facebook, and people loved it. Over the course of the year, I did this six more times. That first photo was taken before Ronnie James started coughing. The last one was taken on the 14th of this month, the day he died… four days shy of the one-year anniversary of the first.

All along, I had no idea that I was capturing the last year of Ronnie James’ life.

Last night marked two weeks since good-bye. I wanted to share these pictures here today, together as a collection. There are only seven. I’d taken many more, but I’d carefully selected the images for this series with certain qualities in mind. Above all, the photos show the special bond between Callaghan and Ronnie James, each one spontaneous and now extra precious in its memorializing the enormous and profound love our feline son carried in his strong little lion heart.

I’ll say it again: Ronnie James loved like no other. He lived from cuddle to kiss, from nuzzle to hug. He measured his days in snuggles, rather than in minutes. He loved to be picked up and carried. He loved to be held, and, unlike most cats, you could hold him until your arms got tired, because the urge to get down never overcame him. He always had to be touching us, including with the unique way he had of flicking his butt to the side to brush against us when walking by. (We thought this quirk of his was so funny and cute.)

The Wrah-Wrah loved all three of us so much, Callaghan, Nounours, and me… and his love was such a huge, constant and present force in our lives that now, the emptiness where he used to be is just crushing. It is to me, at least. I’m having a difficult time with the absence of our “little lovebug” who was actually the greatest source of love I’ve ever encountered in a being, believe it or not. In that sense, he is divine. He’s with us somehow, I know… but still, when I walk through the house and see his favorite places, the realization of his physical goneness sucks the breath out of my own lungs, and I hinge forward under the weight of it.

It’s been rough, friends. Really, really rough. I don’t think that time could help me to miss him less, but it may help me to adapt, eventually.

Without further ado, here are the seven pictures in the “Callaghan and Ronnie James, bonding” series. At the end, I tacked on a pic of me with the Wrah-Wrah (and Callaghan’s leg!), and another of the Wrah-Wrah with his beloved Nounours, both from instagram, as well.

“Callaghan and Ronnie James, bonding”:

 

May 17, 2014. The first photo in the series. Ronnie James hanging out with his Daddy in bed, each of them doing their thing.

May 17, 2014.
The first photo in the series. Ronnie James hanging out with his Daddy in bed, each of them doing their thing.

 

June 2014. Ronnie James often kept his Daddy company in the studio (Callaghan would place the second bar-stool there just for him). This was still back in our old apartment.

June 2014.
Ronnie James often kept his Daddy company in the studio (Callaghan would place the second bar-stool there just for him). This was still back in our old apartment.

 

August 2014. Looking up attentively at his Daddy, probably asking for more belly rubs. He loved his belly rubs!

August 2014.
Looking up attentively at his Daddy, probably asking for more belly rubs. He loved his belly rubs!

 

November 2014. Ronnie James was never happier than when being snuggled by me, Callaghan, or Nounours.

November 2014.
Ronnie James was never happier than when being snuggled by me, Callaghan, or Nounours.

 

December 2014. He loved to drape himself over us. Look at his paw on Callaghan's arm! He loved to touch us.

December 2014.
He loved to drape himself over us. Look at his paw on Callaghan’s arm! He loved to touch us.

 

March 2015. Ronnie James and Callaghan sharing a moment right before we went to France for a week.

March 2015.
Ronnie James and Callaghan sharing a moment right before we went to France for a week.

 

May 14, 2015.  Last photo in the series, almost a year since the first. This photo was taken the day Ronnie James died... just hours before he died, in fact.

May 14, 2015.
Last photo in the series, almost a year since the first. This photo was taken the day Ronnie James died… just hours before he died, in fact.

 

And here are the two extras:

 

August 2014. Ronnie James with Callaghan and me. I remember the ferocity of his purring, he was so happy.

August 2014.
Ronnie James with Callaghan and me. I remember the ferocity of his purring, he was so happy.

 

March 2014.  One of many photos of Ronnie James and Nounours cuddling together.

March 2014.
One of many photos of Ronnie James and Nounours cuddling together.

 

Poor Nounours is so forlorn without his Wrah-Wrah. He still seeks out and cuddles with his brother’s urn and collar.

We will get through this. On Monday, Callaghan left for France suddenly because of an urgent family situation, so he’s preoccupied with the goings-on over there. I’m here with Nounours, doing my best to nurture him through his grief as I work through my own. I value this time to bond more with Nounours. We’re helping each other.

We love you, Ronnie James. As I often used to sing to him: Precious-angel-baby-bunny-dragon-Ronnie-James!

The Wrah-Wrah’s paw print.

Why good morning, friends. As of three days ago, I have a new tattoo, and I wanted to share it with you. It’s a small one, but of all my tattoos, this one is the dearest to my heart.

Right after Ronnie James died, I suddenly, desperately wanted to apply ink to his little paw pads and press his paw onto paper. It wasn’t a thought I’d taken the time to formulate beforehand. As much as I’d tried to prepare myself, his passing was harder for me than I’d imagined it could be, and in the aftermath, I wanted something of him that would stay with me forever.

Since it was a last-minute decision, we were ill-prepared. The inks in Callaghan’s studio yielded fuzzy prints, but we thought we could work with them. They were certainly better than nothing. My idea was to have his paw print indelibly inked on the inside of my wrist, where I could see it all the time. I wanted a permanent, visual remembrance of how Ronnie James loved to touch me, and of how comforting and sweet his touch had been.

 

The Wrah-Wrah's first fuzzy little prints. The one I chose didn't come from this set, but we're going to have this sheet framed.

The Wrah-Wrah’s first fuzzy little prints. The one I chose didn’t come from this set, but we’re going to have this sheet framed.

 

When our house-calling vet brought the Wrah-Wrah’s cremains home to us two days later, she surprised us with another sheet of paper on which she’d stamped some lovely, clear Wrah-Wrah prints, a thoughtful gesture that touched us deeply. I vacillated between my two favorites before deciding on this one:

 

Getting an idea of how it would look....

Getting an idea of how it would look….

 

Callaghan loved it and decided to get the same tattoo. We went to the Club Tattoo down the street here in Tempe to make an appointment with the person who’d done my last (spiral of hearts) tattoo. We made our double appointment for Saturday afternoon.

 

Ronnie James' paw print realistically done in four shades of black/gray.

Ronnie James’ paw print realistically done in four shades of black/gray.

 

The same tattooist did that spiral of hearts around my arm in 2011, right before the move to France. (In case you're wondering, no, I don't lift weights. I just do Body Combat 3x / week. I do want to get back in the garage to work out, though... it's been a good couple of months.)

The same tattooist did that spiral of hearts around my arm in 2011, right before the move to France. (In case you’re wondering, no, I don’t lift weights. I just do Body Combat 3x / week. I do want to get back in the garage to work out, though… it’s been a good couple of months.)

 

I explained to our tattooist that I wanted the tattoo to look smudgy and real, as if Ronnie James’ inked paw had been pressed directly onto my wrist. He expertly used four shades of black/gray to achieve the effect with shading. I’m extremely pleased with how it turned out. I absolutely adore it.

 

Now I'll always have the Wrah-Wrah's paw on me.

Now I’ll always have the Wrah-Wrah’s paw on me.

 

And here’s a bad selfie, just for fun. (How do people take mirror selfies, anyway? It never worked out the few times I tried it. It must be an art form.)

 

Thwarted by lighting! Useless selfie attempting to show my freshly bandaged wrist... but you can see Callaghan in the background getting his tattoo done, so there's that.

Thwarted by lighting! Useless selfie attempting to show my freshly bandaged wrist… but you can see Callaghan in the background getting his tattoo done, so there’s that.

 

Callaghan loves his tattoo, as well. He asked to have the print altered just a tiny bit, and we wanted ours angled slightly differently, and he positioned his further down his wrist than mine, and he has his on his left wrist, while mine is on my right… so our Wrah-Wrah prints aren’t exactly identical. The Wrah-Wrah loved us both, but differently. He touched us both, but differently.

The Wrah-Wrah is Forever.

The Wrah-Wrah and the Rutin. (Help!)

Hmm… I’m thinking it might be a good idea to create a “Cat Mom Blog” category so I can file these Ronnie James posts in one place….

Today, I have a question that I hope someone can answer: How do you get a cat to eat something he loathes?

This is a life-or-death problem we’ve been having, and we’re feeling like we’re out of options.

Ronnie James needs to take rutin. Rutin is not a medication. It’s a dietary supplement, and it’s evidently the only thing that cats can take with any degree of effectiveness for chylothorax. It can potentially stop or at least slow down the flow of chyle into the pleural cavity. It also tastes horrible, and Ronnie James will have none of it.

 

It smells like paint thinner.

It smells like paint thinner.

 

We’ve tried everything. We had Diamondback Drugs, our compounding pharmacy, formulate it into a liquid flavored with chicken. They warned us that he probably still wouldn’t like it, but we might have more luck mixing it into his food that way.

We mixed the chicken-flavored rutin into the Wrah-Wrah’s favorite wet foods, including his current most favorite of all (which, oddly, is one that was prescribed by his primary care physician), and he refused to eat it.

After his surgery, we tried again, to no avail. Finally, in desperation, we returned to the direct approach and injected the rutin into his mouth with the plastic syringe. He threw it up, along with his antibiotics and everything he’d eaten. He was abjectly miserable. We felt awful. We stopped trying and went back Dr. M. in defeat when it came time to remove Ronnie James’ stiches.

The following week brought us to Thursday night and our harrowing trip to the E.R. No one could understand how so much fluid had filled up Ronnie James’ little chest cavity so quickly. He HAD to take his rutin. While there was no guarantee that it would work, it would at least give him a chance at survival if it did. We had to try to give him that chance, and we had to somehow do it without stressing him.

Another order for rutin had been called in to Diamondback Drugs – tuna-flavored, this time. We were hoping we’d have better luck with the tuna, since Ronnie James loves tuna; we figured that strong-smelling fish might mask the rutin flavor well enough if we mixed them together.

Diamondback Drugs was closed on Sunday, so yesterday, Monday, Callaghan picked up the rutin. He stopped by my office on his way back to pick me up for lunch. We got home and went straight for the can of herring waiting on the kitchen counter. Operation Rutin was back in effect!

Two little plates of herring were prepared for the kitties’ lunch: Ronnie James’ contained the rutin. He tentatively sniffed his plate of herring, and then he walked away.

I knew that walk. It was the “I know there’s rutin in that food and I’m outta here” walk. It wasn’t that he didn’t like herring, or that he just wasn’t hungry, either. He went to Nounours’ plate and ate some of his herring. Nounours’ rutin-free herring.

We were beside ourselves. What was it going to take to get Ronnie James to eat the rutin?

Meanwhile, he needed something for lunch, so I fixed a clean plate of his normal, favorite food. (The other issue we’re having is that he’s not drinking enough water, so we’re giving him his favorite wet food at every opportunity.) I set the good stuff down in front of Ronnie James. He looked at it askance, then walked away again.

This time, it was the “I strongly suspect you snuck rutin into that food and I’m outta here” walk. He hadn’t even gotten close enough to smell it thoroughly! He was just convinced that the rutin was in there. We were now having trust issues.

I thought for a minute, then looked over at Ronnie James. He was sitting in the hallway at the kitchen entrance, watching me. Exaggerating my motions and holding his gaze with my eyes, I took an unopened can of his favorite food, waved it before me, and said, “Let’s open a brand-new can!” I reached for another fresh kitty plate, took a clean fork from the drawer, and brought everything to the kitchen entrance where he was sitting.

He kept his eyes on me as I made a big production of holding up the can and opening it, garnishing my actions with a little dramatic flair. He watched attentively as I scooped out a generous forkful, tapped it onto his plate, and set it down in front of him.

He started eating immediately.

He didn’t even sniff it first. He just knew that there wasn’t any rutin in it, because why? Because this cat is a brilliant genius. And we are screwed.

After the rutin-laced fish failure, Ronnie James had looked warily at the clean plate of his untainted favorite food and refused to touch it. But when he witnessed me opening a new can of the same food and filling his plate, he dug right in. He saw that the can was unopened, he saw that I transferred food directly from it to the plate that he saw was clean, and he saw that I put it down without adding anything to it… and the neurons in his brain made all the connections and arrived at the conclusion – food is safe – instantly. Callaghan was as astonished as I was. We’d known that we had an exceptionally smart kitty on our hands, but still, we were floored by this display of cognitive agility and capacity for comprehension.

 

Ronnie James is on to you!

Ronnie James is on to you!

 

It might seem like I’m just letting my proud cat mom colors show here, but really, I’m more just very concerned that there’s no way we’re ever going to get Ronnie James to eat his rutin. Even if we get it down his throat, he throws it up. We can’t outsmart him. Actually, we sniffed the rutin in its bottle, ourselves, and it doesn’t even smell like tuna. It smells like an industrial chemical! It’s atrocious. It literally smells like poison. I’d think that any sane, smart cat would instinctively reject it.

Isn’t there a better way? Has anyone ever had to give rutin to a cat?

We would greatly appreciate any suggestions or advice you could offer. Meanwhile, I’m going to call Diamondback Drugs again to ask if there’s any other way they could compound this stuff….

The Wrah-Wrah goes to the E.R. (and proves once again that he has more lives than the average cat.)

Well, that was a night.

Ronnie James is back in the hospital. After a few days of observing him, calling the hospital, making appointments and then canceling them as he’d seem not-fine one minute and then much better the next, not knowing what his new “normal” is supposed to look like after his surgery (like all cats, Ronnie James is incredibly skilled at hiding the extent of his discomfort), we knew last night that he needed to go to the E.R.

A technician triaged Ronnie James the minute we got there, then immediately took him to the ICU and put him on oxygen. It was scary – scary enough for the doctor to come in and warn us that the Wrah-Wrah might not survive the thoracentesis that had to be done – but the little guy made it through. He was looking much better when we kissed him goodnight before coming home. He was alert and active in his oxygen chamber, being his usual flirty, affectionate self. He’s unbelievable! We were cautioned that he’s not “out of the woods” yet, but he’s looking just as spry as ever!

We shouldn’t have been surprised by this development, as Dr. M. had clearly warned us that Ronnie James would likely require one or two more thoracentesis (chest tap/draining) procedures following his surgery. We were prepared for this likelihood. We just weren’t prepared for the situation to arise in such a dramatic and scary way. I mean, we truly almost lost him last night.

The E.R. doctor, who was wonderful, showed us Ronnie James’ x-rays and said, “Look at this… I don’t know how he was still alive!”

The Wrah-Wrah is a miracle kitty, that’s how.

His x-rays showed nothing but white. On a normal chest x-ray, dark areas of a healthy size and shape would be visible. Those would be the lungs with air in them.

In this one view of Ronnie James’ chest, there’s no dark area to be seen at all:

 

Thursday, 4/23/2015 - Wrah-Wrah's chest cavity is completely filled with fluid. No lung is visible.

Thursday, 4/23/2015 – Wrah-Wrah’s chest cavity is completely filled with fluid. No lung is visible.

 

And in this view, the side view, you can see a small, grayish area with rounded edges “just kind of floating there.” That’s the Wrah-Wrah’s lung. It was surrounded by so much fluid that it was barely functioning. It’s like a ghost lung.

 

Thursday, 4/23/2015 - That faint, ghostly dark roundish area in the center, just below his spine? That's his "lung." That's all he has left, and with all the fluid crowding it, it was barely working.

Thursday, 4/23/2015 – That faint, darker gray area in the center, just below his spine? That’s his lung.

 

The doctor talked to us carefully and made sure that we understood the precariousness of the situation before he performed the thoracentesis. The procedure was extremely high-risk because Ronnie James’ condition was life-threatening. But everything went well. 300 ml of chyle was aspirated, and that wasn’t even all of it!

 

Thursday, 4/23/2015 - This is the fluid that was taken from Ronnie James' chest cavity. It's 300 ml (a cup and a quarter), and it's not even all that was in there. The doctor didn't want to try to drain all of it, because it would have been too risky. The fluid is chyle (chyle can either be cloudy or pink).

Thursday, 4/23/2015 – This is the fluid that was taken from Ronnie James’ chest cavity. It’s 300 ml (a cup and a quarter), and that was just some of it. The fluid is chyle (chyle can either be cloudy or pink).

 

There’s still “quite a bit” of chyle left in the Wrah-Wrah’s pleural cavity. The doctor said that it was too dangerous to try to get it all, but enough was removed to allow for more normal breathing. They might try to remove a little more sometime this morning.

Now, we wait to hear from Dr. M. when he comes in, examines Ronnie James, and reviews the whole situation. We don’t know what’s going to happen next. It’s at least comforting to know that what has happened so far had been anticipated… and the E.R. doctor said that he’s hopeful. Also, most importantly, the Wrah-Wrah isn’t suffering continuously.

 

Thursday, 4/23/2015 - Ronnie James felt better after his thorocentesis. He was wide-eyed, active and heart-meltingly lovey-dovey when we went to visit him in his oxygen chamber before we left.

Thursday, 4/23/2015 – Ronnie James felt better after his thoracentesis. He was wide-eyed, active and heart-meltingly lovey when we went to visit him in his oxygen chamber before we left.

 

Look at those wide, bright eyes!

We’re keeping our thoughts positive.

Ronnie James has a new nickname: Cat Squared (he has 81 lives, apparently)

I wanted to thank you all again for thinking of us and taking part in our journey to better health for Ronnie James with your kind well-wishes and interest in his story. I didn’t mean to tease in my last post. I just didn’t have much time for writing last week! Also, I wanted to talk to our doctor again before I sat down to scribble this out.

This is the short story:  Ronnie James was sick and gradually dying when we rescued him in the fall of 2012, but we didn’t know anything was wrong until he started coughing about 11 months ago. We now know that he’s been evading death for years, somehow surviving a thing that would have killed most mammals. We are in awe of him.

 

Ronnie James, Sunday night, 4/12/2015. Angel kitty with his halo of lights!

Ronnie James, Sunday night, 4/12/2015. Angel kitty with his halo of lights!

 

The detailed story goes like this:

In the operating room on Friday, April 3, Dr. M, our surgeon, opened up Ronnie James and found his left cranial lung lobe in a state of semi-decay; he said it almost looked like it was “rotting” in his chest. The mysterious mass seen on the CT scan turned out to be a mushroom-shaped (“pedunculated”) object that oozed a “weird, thick mucus-like material” when the stem broke off.

Dr. M tried to describe what he saw in the center of the mass, but he couldn’t quite find the words. I got the impression that he’d never seen anything like it before.

He told me, “It looks like it might be something of an infectious nature,” but he seemed to be baffled. He suggested that the mass might be a remnant of an old infection that Ronnie James’ body had tried to wall off. As he spoke, I envisioned an oyster protecting itself from grains of sand by coating the foreign material with its own bodily secretions.

But the bulbous, sickly pearl inside Ronnie James almost killed him. At first, its point of origin wasn’t obvious; it appeared to be attached to the bottom of the left cranial lung lobe. Actually, it seems to have grown off of one of the bronchi, clogging it and causing the lobe to collapse and consolidate. It’s possible that the mass ultimately caused blockage of Ronnie James’ thoracic duct, either directly or indirectly, as it was on the same (left) side. We’re hoping that this was the case, because if it was, then it answers the question of “What caused his chylothorax?”

Chylothorax, the filling up of the chest cavity with chyle, was the chronic issue we were aiming to fix, the problem we had to solve in order to save Ronnie James’ life. If the mass was causing it, well, problem solved! The mass is gone now.

Our surgeon said, “Until the labs come back, we can’t rule out cancer. I’ll tell you what, though… this doesn’t look like any cancer I’ve ever seen. I don’t know what this is.”

All along, Ronnie James’ labs have consistently tested negative for cancer. Dr. M had to say that he couldn’t rule out cancer until the labs came back, but the fact was, no one really thought that it was cancer.

Whatever it was, it was weird.

The weirdest thing was that standing before our kitty’s exposed insides, Dr. M and his team were still more or less flummoxed. Nothing was adding up or making sense, but he went ahead with the planned lung lobectomy, which was absolutely what had to be done, and removed “the entire mass and left cranial lung lobe as well as a small amount of an adherent adjacent lung lobe.” Samples of everything were sent to the lab for analyses and cultures.

While Dr. M was working in Ronnie James’ chest cavity, he also did an ultrasound on the second, smaller mass the CT scan had detected in Ronnie James’ neck.

 

Ronnie James' left cranial lung lobe, part of an adjacent lobe, and the mass were removed. The mass seemed to stem from one of his bronchi.

Ronnie James’ left cranial lung lobe, part of an adjacent lobe, and the mass were removed. The mass seemed to stem from one of his bronchi.

 

When the lab results came back a few days later, they showed that the inside of the lung mass was comprised of fat necrosis (dead fat). Necrotizing tissues and edema were also found throughout the lung lobe. There was “scattered mineralization.” We were indeed looking at decaying organic matter and an old infection, an infection with a history… and it was chronic.

Considering all of this, it’s miraculous that we didn’t lose Ronnie James to something like sepsis or cardiac arrest. Other than his intermittent episodes of coughing and his more recent bouts of prolonged lethargy, he had seemed just fine. He’d initially been diagnosed with asthma, which he may or may not actually have.

But what could have caused Ronnie James’ ancient infection? He’d tested negative for Valley Fever. He’s been an indoor cat since we’ve had him, anyway. We couldn’t stop thinking about it… we were faced with a medical mystery that had to be solved so we could take the best next steps toward complete recovery. It was maddening. What could have wreaked all this havoc in Ronnie James’ pleural cavity?

Then we thought back to the first time we ever took Ronnie James to the vet, when we were still living in France, and we remembered the cause of that problem. It was the Chenille Processionnaire, and it explains everything.

 

Chenille Processionnaire, or Pine Processionary.

Chenille Processionnaire, or Pine Processionary.

 

In October 2012, soon after we adopted 8-year-old Ronnie James from an impoverished woman in Montélimar in southeastern France, we noticed that he was having trouble eating. We took him to the veterinary clinic closest to us, which was down in Bourg de Péage. (In France, our home-base was in the Alpes, about 100 miles from the recent plane crash. I’m sorry to be able to use the location of that awful event as a point of reference, but there it is.) We thought that dental problems might be causing him pain, but when the vet opened his mouth, he simply remarked that Ronnie James had experienced some sort of contact with a Chenille Processionnaire (“Pine Processionary” in English), a venomous caterpillar common in southern France. The tip of Ronnie James’ tongue had been “burnt off,” and it was this disability that impeded his eating. Our vet immediately recognized the characteristic chenille processionnaire damage to Ronnie James’ tongue; there was no question about it.

I’d never heard of anything like it. The Pine Processionary doesn’t exist in the United States. According to Wikipedia, it’s only found in southern Europe and in parts of Asia and Africa.

From what we can understand, animals such as dogs and cats are harmed by this caterpillar either because of poisoning from its venom, or because of an allergic reaction to it, or both, in any case being potentially – even often – fatal. Incidentally, I found some disturbing images of dog and cat tongues either burned, like Ronnie James’ tongue, or amputated at the tip (due to contact with this caterpillar).

 

Les Chenilles Processionnaires (Pine Processionary caterpillars) are often seen traveling end-to-end. They're common where we lived in the Alpes and all over the French Riviera.

Les Chenilles Processionnaires (Pine Processionary caterpillars) are often seen traveling end-to-end. They’re common where we lived in the Alpes and all over the French Riviera.

 

The caterpillar’s venom is released when its tiny hairs break off, or when the caterpillar ejects the hairs in self-defense. The toxins are in the hairs. Dogs and cats suffer when they have direct interaction with the caterpillar, or when they come into contact with pine needles or other organic matter on which the caterpillar’s hairs had fallen. Ronnie James could have licked the caterpillar, or he could have stepped on the hairs while walking around outside, or, more likely, knowing him, he might have played with the caterpillar with his paws, batting it around. Whether he walked on the hairs or played with the caterpillar, the toxic hairs would have stuck to his paws (they stick to whatever they touch), and Ronnie James’ tongue would have been burned when he went to lick his paws, as cats do.

At the same time, a venomous hair or two could have traveled down into Ronnie James’ lungs.

It happens. It happens to dogs and cats who roam outside in areas infested with the Pine Processionary.

Dr. M, who had (along with the rest of his surgical team) noticed the unusual damage to Ronnie James’ tongue when they were prepping him for surgery, agrees that more than likely, this is what happened to him. Though we didn’t witness the caterpillar encounter, we can all look at the evidence before us and do the math. In this case, 2 + 2 = Pine Processionary caterpillar damage in the Wrah-Wrah’s lungs. It would also account for the smaller mass found in his neck, lodged in his throat area, as the way that was presenting also matched the type of damage that could be done by the Pine Processionary.

Everything we can see points to this caterpillar.

Two things are for sure: Ronnie James survived an inordinately long time after his encounter with the caterpillar, and he was certainly dying by the time the surgeon removed the dead lung and surrounding infected areas. And we’re not finished yet. One of his lab cultures came back positive; the infection is alive.

 

thatasianlookingchick.com-pineprocessionarycaterpillar

 

One for the “WTF, Nature?” archives, if you ask me.

We’re so proud of Ronnie James. He’s been such a good sport throughout this ordeal, and he did extremely well in surgery. Everyone was surprised when he didn’t need oxygen therapy to transition out of anesthesia, as dogs and cats typically do after surgery. He started breathing on his own again as soon as they unhooked him! We credit this bit of badassery to the fact that the Wrah-Wrah had long since learned to get along without that nasty old lung.

So that’s what happened. Years ago, Ronnie James inhaled or ingested toxins from a caterpillar. And to think that I’d blamed myself for bringing him here, back when we thought he’d developed asthma from being in the dusty desert! The whole time, he’d been suffering the effects of an environmental hazard that doesn’t even exist in North America. I can’t believe we brought this demon caterpillar venom back from France with us, embedded in the Wrah-Wrah’s lungs. That was more baggage from France than we’d bargained for.

Now that we know the root of the problem, we have a better idea of what to do for Ronnie James. We’re going after the remaining infection with an aggressive, extended course of antibiotics. We’re also continuing him on his asthma treatments, as he’d shown slight improvement on them (the steroid inhaler was helping to hold the infection at bay, and the bronchial dilator inhaler was helping to open up his airways).

Tomorrow, the Wrah-Wrah goes back to Dr. M to have his stitches removed, and he’ll be checked for need of further thoracentesis (chest tapping/draining). We were cautioned that it wouldn’t be unusual for him to need to have his chest drained one or two more times following the surgery. Our hope is that after a month or so, he’ll no longer have to deal with chylothorax and all the treatments it necessitates.

We’ve had a couple of scary episodes with coughing and vomiting in the last few days, but he checked out fine at the hospital; the episodes aren’t surprising given that his insides are adjusting to the changes, and he’s still recovering. Overall, the Wrah-Wrah continues to do much better. He’s happy and more active now than we’ve ever seen him. He is exponentially better, in fact. He’s next-level Wrah-Wrah!

A happy kitty is a kitty without dead lung tissue rotting in his chest with a weird, bulbous, rotting-fat-filled mass. We still have a long road ahead of us; Ronnie James’ long-term prognosis depends on how he responds to treatment from this point on. Anything can happen, but we’re optimistic!

 

Sleepy Ronnie James. He just woke up from his evening nap. (4/13/15)

Sleepy Ronnie James. He just woke up from his evening nap. (4/13/15)

Frankenkitty Comes Home!

Or, shall we say, the FrankenWrahWrah.

Ronnie James, one week post-op. (4/10/2015)

Ronnie James, one week post-op. (4/10/2015)

The results of Ronnie James’ surgery are unbelievable, better than anyone thought possible.

Friday, 4/3/2015, Day Zero: Our first sight of Ronnie James after his surgery, about five hours post-op. Still coming out of anesthesia, heavily medicated.

Friday, 4/3/2015, Day Zero: Our first sight of Ronnie James after his surgery, about five hours post-op… still coming out of anesthesia, heavily medicated.

Hello, Wrah-Wrah!

Hello, Wrah-Wrah!

He’s half hairless. He’s got a five-inch-long incision with about 20 stitches, plus a few stitches closing up the hole where his chest tube had been. He’s minus his left cranial lung lobe, part of an adjacent lung lobe, and a mysterious mass, and he’s breathing much easier now!

Poor Nounours missed his brother so much, he literally waited at the door for him to come home (when he wasn't wandering around the house crying).

Poor Nounours missed his brother so much, he literally waited at the door for him to come home (when he wasn’t wandering around the house crying).

We were all kind of confused going in, but the truest story of the Wrah-Wrah could be seen when our surgeon opened him up and looked inside. The phone call I received at work after the surgery was bizarre because what the surgeon found was bizarre. It fact, it was so bizarre, I have to save the story for the next post.

Meanwhile, here are some pics of our little warrior!

Saturday, 4/4/2015, Day One: The day after his surgery, we went from the gym directly to the hospital to visit Ronnie James. We were allowed to hold him. He was so out of it and scared!

Saturday, 4/4/2015, Day One: The day after his surgery, we went from the gym directly to the hospital to visit Ronnie James. We were allowed to hold him. He was so out of it and scared!

Sunday, 4/5/2015, Day Two: When we brought him home on Sunday night, Wrah-Wrah went straight to my office to rest, relaxed on his pain meds.

Sunday, 4/5/2015, Day Two: When we brought him home on Sunday night, Wrah-Wrah went straight to my office to rest, relaxed on his pain meds.

His fur had been shaved so precisely for the surgery, it looks like he's wearing half a coat! That spot in the center is where his chest tube had been.

His fur had been shaved so precisely for the surgery, it looks like he’s wearing half a coat! That spot in the center is where his chest tube (for drainage) had been.

That is quite an incision there, little guy.

That is quite an incision there, little guy.

Monday, 4/6/2015, Day Three: Pain-killers in full effect! The kitties' toy area in the living-room has been one of Ronnie James' favorite hang-out spots since he's been home.

Monday, 4/6/2015, Day Three: Pain-killers in full effect! The kitties’ toy area in the living-room has been one of Ronnie James’ favorite hang-out spots since he’s been home.

So many toys! Too many decisions.

So many toys! Too many decisions.

Tuesday, 4/7/2015, Day Four: We had a rhythm going with Ronnie James' after-care. Between his different meds and his compress treatments, there's something to be done six times each day. He's doing so well!

Tuesday, 4/7/2015, Day Four: We had a rhythm going with Ronnie James’ after-care. Between his different meds and compress treatments, there’s something to be done six times each day.

He's spent a lot of time snuggling up to me in my office at home.

He’s spent a lot of time snuggling up to me in my office at home.

Thursday, 4/9/2015, Day Six: Breathing so much easier now!

Thursday, 4/9/2015, Day Six: Breathing so much easier now!

We’re so grateful to everyone involved in the Wrah-Wrah’s medical journey (which isn’t quite over, but we’re certainly off to a great start!) and well-being, from the doctors and staff at our two clinics to all of you who’ve been keeping him in your thoughts and prayers. Next week I’ll fill you in on What the Heck the Surgeon Found. 

Happy Friday, All!

Ronnie James update Number 2 – Out, damned mass!

Sorry… I couldn’t resist the Shakespeare reference.

I’m postponing my March Favorites post until Tuesday, since this morning we had to take Ronnie James (Wrah-Wrah!) to the hospital super early. A lot more has happened since my last post about the Wrah-Wrah… that post, you know, in which we were so relieved and optimistic. In fact, since that very day I updated you guys, something else happened (as you know if we’re Facebook friends), and it’s continued to be an up-and-down kind of situation. The new developments have been relentless, and now, this morning, Ronnie James is going into surgery. The surgeon is going to perform a lung lobectomy to remove one Ronnie James’ lung lobes – the one with the mass, which may or may not be cancer, and which may or may not be causing his chylothorax, either because it’s cancer, or because structurally, it’s creating a blockage of his thoracic duct. In any case, the mass has to go. We consulted with several doctors at two different places, and everyone agrees that we can’t not take a serious measure at this point. He had to have another 150 ml of fluid removed from his pleural cavity the other day. We have to at least try to stop the flow of lymphatic fluid into his chest.

Because other than this, Ronnie James is very healthy, happy and active. He has a great appetite. He’s not at death’s door, so to speak. He’s not saying, Mommy and Daddy, I’m ready to go. He’s just saying, Mommy and Daddy, please stop the coughing. And so we’re going to try. Here are some pre-op pics, starting from late last night:

Ronnie James the night before his big surgery adventure! (4/3/2015)

Ronnie James the night before his big surgery adventure! (4/3/2015)

We've arrived at the hospital. Ronnie James is snug in his carrier, reassured under Daddy's touch. (4/3/2015)

We’ve arrived at the hospital. Ronnie James is snug in his carrier, reassured under Daddy’s touch. (4/3/2015)

Off to get tucked into his cozy hospital bed! Jordan loves the Wrah-Wrah, too. (4/3/2015)

Off to get tucked into his cozy hospital bed! Jordan loves the Wrah-Wrah, too. (4/3/2015)

Ronnie James will likely remain in the hospital under 24/7 care through Sunday. With the exception of the gym on Saturday morning, we’ve canceled our weekend plans so we can spend lots of time visiting him.

Thank you for your kind thoughts, prayers and well-wishes! I’ll post an update next week.

Happy Friday! =)

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.