I have just published a full accounting of the Artemis Medical Fund. Thank you so much for your generosity. In summary, your donations covered all costs, and the remainder was almost the same as the total from people who told me to keep the remaining funds myself. There was a small difference, a little over $50, so I’ve made a $100 donation to the Cat Protection Society of NSW through their online donation page at Everyday Hero.
Artemis breathed her last breath at 12.37pm AEDT today. It was a peaceful moment. I held her while she moved from this world into the next. I cried. I am crying now.
Artemis led a gloriously adventurous life, if perhaps short at a little over seven years. She hunted everything from moths and grasshoppers to rats and noisy miner birds, eating most of them. She even brought us the striped marsh frog from the garden pond — three times before she learned, the hard way, that it’s poisonous. She never did catch a currawong, and I’m glad of that.
Artemis used up one of her nine lives when her tail was crushed and eventually amputated.
Today I chose to take her ninth.
Thanks to today’s X-rays and ultrasound, we have some answers. Sadly for Artemis, the answers are not good. Not good at all.
Artermis’ left kidney is quite small, only 2.8cm long. A normal cat kidney might be 3.5 to 4.5cm. Perhaps she was born with it small, perhaps it’s been damaged later. Kidneys do shrink with some chronic problems. But either way, it’s clearly dodgy.
The right kidney is bigger, but there’s a kidney stone. It’s only 1.5mm in diameter, but we’re talking about a cat not a human. That stone is currently blocking the urethra, and perhaps a back-up of urine is inflating that kidney. It’s possible the stone has only just moved there, which could explain the reversal of Artemis’ blood results over the past few days.
Now if this were simply a kidney stone, we’d just operate and remove it. “If it was just that one kidney, the prognosis wouldn’t be too bad,” Dr Payne said. But with the other kidney clearly not right? “The outlook isn’t that great.”
Since so many people now have a stake in Artemis’ future, I’ll present the options and ask for your advice.
Well that’s not good. With intravenous fluids reduced to 1.5x maintenance levels for two days, Artemis’ blood test results headed in the wrong direction. We now need to discover if there’s some reason for the kidneys not working other than, well, failed kidneys.
Creatin levels climbed back to 690. Urea was back up to 22.7, although that’s not the worst it’s been. Red blood cell count is still low, in the mid-20s instead of the 30+ it should be in a cat — although that’s possibly just a symptom of the high fluid levels. Electrolytes are still a bit whacky.
So Artemis goes back on the 2x maintenance levels of intravenous fluids — the poor man’s dialysis — until we figure out what’s going on.
And yet, Artemis has reportedly been “even more feisty” than she was on Sunday. She’s been eating overnight, she’s interacting with staff, and she’s showing all the signs of simply being frustrated with having to be in a cage.
After consultations with a specialist at the University of Sydney, a plan has been agreed upon. Ultrasound, X-rays and attempts to culture potential infectious agents to see if there’s some treatable cause of the kidneys not working. That’ll begin tomorrow and we’ll have news of the ultrasound and X-rays around 24 hours from now.
If none of those procedures reveal anything treatable, then we’re looking at untreatable kidney failure. It may not be that. But it’s a distinct possibility, despite Artemis’ apparent external health.
As for exploring the options, there is a veterinary surgeon in Melbourne who does kidney transplants. Enquiries have been made, and we’ll see what the requirements are, but… you know… We’ll see.
Artemis’ latest blood results have just been phoned through. Creatin has continued to drop, from 416 to 376, slowly moving towards the normal maximum of 212. Urea is down from 36 to 19.5, again moving steadily towards the target 12.9. Phosphorus and calcium have stabilised. Her red blood cell count is low, but that’s possibly just because she’s on such a high rate of fluids.
The decision has been made to reduce the flow of intravenous fluids down to 1.5x maintenance levels, rather than the 2x she’s been on, and see what happens over the next 48 hours. For the background to that, see the post from earlier today.
“We’re looking at the possibility we could get [her] through it,” says Dr Meredith Gibbs.