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….

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.