We arrived just before noon on Monday–Labor Day in the U.S.–to bring Toby home from the emergency veterinary center, where he had been since Thursday.
This emergency facility is located on Kapiolani, across Kona Street from Ala Moana Center. I can describe the location through all the things that were once there but aren’t anymore. Location via absence? Sounds strange, but sometimes it works.
There was a mattress store at this location for some years which seemed to always have a sale going on. As I recall, the space served as political headquarters for several Democratic candidates during at least one election cycle. China House restaurant used to be up the ramp. Antique Alley occupied a ground floor space for many years before moving to their current location on Queen Street. A nightclub associated with the wife of a judge I once investigated back in my Star-Bulletin days was in the rear towards Kona Street, and at one time the Hawaii Newspaper Guild office was upstairs.
So it felt like I knew the place well, although we hadn’t set foot in the veterinary center until taking Toby in on Thursday.
We had a long consultation Sunday evening with one of their vets, Dr. Coleman, and were able to get our primary vet, Ann Sakamoto of the Hawaii Kai Veterinary Clinic, involved in the three-way conversation.
Unfortunately, we learned it is not a good situation. Toby had not responded to the several days of intensive treatment with two different antibiotics and, worse, had been overloaded by the attempt to flush his kidneys and now faced an excess of internal fluids. So they had stopped the fluids, and given him a small dose of diuretic to try to reduce his water load without straining his kidneys too much. With the antibiotics and fluids failing to register, his appetite nonexistent, and his affect increasingly lethargic, it seemed the end of the road. Not much else that could be done medically except to continue the same treatment and hope.
We decided to shift to hospice mode and palliative care at home and, in the face of the inevitable, euthanasia in a comfortable setting. We had been preparing to deal with these harsh facts of life and death, and it seemed time was nearly up.
But when we arrived to pick Toby up, we were told the vet on duty wanted to speak with us. We were shown to one of those sterile little exam rooms. There were two straight back chairs on one side of the room, plain black plastic upholstery. Small cabinets, upper and lower, with a short counter holding a computer, telephone, and a paper towel dispenser on the wall next to the door. No other furniture. On one wall, a stainless steel exam table could be folded down for use, Murphy Bed-style. We waited a few minutes, then Dr. Crispell knocked and entered the room. White coat, carrying a clipboard. She stood. We were still sitting. Waiting. She got right to the point.
“I know that you’re planning on taking Toby and arranging for home euthanasia,” she said, looking at us. “But…”
That word hung in the air between us. “But…”
She went on. “But Toby started eating last night. And he ate again this morning.”
Toby hadn’t eaten since his arrival on Thursday. They resorted to force feeding once on Saturday night, and he had eaten a couple of teaspoons of food we brought when we visited on Sunday morning. Other than that, he had pretty much ignored any food that had been offered. but that had dramatically changed beginning Sunday night. His blood test earlier that day had not shown any appreciable change, but the sudden appetite could be huge.
“So,” Dr. Crispell said, again looking at us intensely. “I hope that you will watch him for several days before making any decisions. If he keeps eating, that would be a very good sign.”
She broke a small smile. “I don’t want to give you too much hope, but….”
That word again. We grabbed it and have held tight.
Toby has been home for nearly 24 hours. He’s eating enthusiastically, even eating the prescription food for kidney patients. We’re armed with a week’s worth of the antibiotic, anti-nausea pills, antacids for cats, and an appetite stimulant “if needed.”
I thought all but the antibiotics were sort of optional or “use as needed,” but got schooled today by Dr. Sakamoto, who explained that when kidneys go down, there’s lots of chemistry that the nausea/antacid pills attempt to deal with. So he’s getting the whole shebang until further notice. And we’ll have to start subcutaneous fluids later in the week. That will be its own adventure.
We don’t know where this is going, but we’re all on board for the ride.
A photo of Toby on today (Tuesday morning)…
