Artemis improves, but it’s early days yet

I’ve just spent half an hour with Artemis, and here’s a picture. While she’s showing marked improvement, she’s still on fluids at twice the normal maintenance level to flush out any toxins — think of it as poor man’s dialysis — and it’ll still be some days yet before we really know what’s going on.

First the good news. Artemis has been eating. While she was obviously annoyed at still being connected to the drip, she was exhibiting her normal behaviours. I’m friendly, but don’t touch me. Yes, I want attention, but don’t pick me up. How can I escape from this table? How can I get my leg out of this uncomfortable bandage? This is a great sign.

However she needs to stay in this stable state without being on intravenous fluids.

As I mentioned earlier, the blood tests done on Friday afternoon showed that the enzymes associated with kidney problems had been declining, although they were still way above normal levels. Urea levels, for example, had dropped from 113 during the crisis night to 36, but they should be below 12.9. Creatin levels were at 416 on Friday, when they should be below 212. On crisis night they were so high that the measurement technique didn’t even work, even with the blood sample being diluted.

Curiously, certain blood tests showed indications of acute kidney problems, but others were associated with chronic problems.

In brief, as I discussed with Dr Meredith Gibbs today, Artemis was so profoundly ill — so near death! — that everything was very different from normal. We shouldn’t read too much into any of this, but simply take everything one step at a time.

And the next step is further blood tests this afternoon, 48 hours after the last batch. If all these enzyme levels are returning to normal, then the intravenous fluids will be reduced slowly to see what happens — to see whether Artemis’ kidneys can now sustain their function or not. If the blood tests are not showing sufficient movement towards normal today, well, she stays on the high-level fluids for another 48 hours. And then we try again.

So what’s the longer-term view?

Dr Gibbs, as well as the other vets at Pet Vets these past few days, have all stressed that the range of possible outcomes at this point covers the entire gamut. At one end is complete recovery, perhaps because this acute kidney failure was caused by some random toxin and there’s no or little permanent kidney damage. At the other end is severe kidney damage that will never be manageable. In between are various scenarios and various techniques for managing less-than-perfect kidney function. As I say, it will take some time yet to discover where we sit on that spectrum.

And on top of that, if you’ve been following this story you’ll know that there’s still the problem of those lesions in Artemis’ mouth. Cancer? Mere side effect of this kidney problem? We simply don’t know at this stage. Taking a biopsy requires Artemis being able to process the anaesthetic that’d be needed. She’s not there yet. Should we do ultrasound to look for other signs, other potential causes? Well, none of that would change what we’re doing right now, so let’s not waste time and money doing random procedures.

One. Step. At. A. Time.

Deep breath. Patience. We’ll discover things as we discover them.

Meanwhile, I continue to appreciate everyone’s support. Thank you so much for your messages and your donations — which have now exceeded $3000. And Dr Gibbs was astounded last night to be asked at a social function, when she said she worked at Pet Vets, “Oh, are you taking care of a cat called Artemis at the moment? How is she?”

I will post a brief post this afternoon when we have today’s blood test results.

Apart from that, I will only post when there is specific news. Alas, I do have to focus on everything else in my life, such as the Patch Monday podcast production later today and… oh… yes… preparing for the househunting.