When I took him in, his Xrays hadn't improved at all since the previous week. That's bad. His chest was still solid white, and you couldn't make out any structures at ALL. Not the heart, not anything. All we could really see was a solid white squiggle in the chest below the esophagus, which the vet said was probably calcified tissue. The esophagus was still pushed up against the spine, and he was still in really bad shape.
They kept him all day and told me that we'd know by 6PM if I could come pick him up, or if I'd be coming to say goodbye. They needed time to check his electrolytes and run the EKG. If his electrolyte levels were low, it would mean that it was too dangerous to increase the dosage of his diuretic, and we would have no other way of getting the fluid out of his chest. Once again, the chest tap produced no liquid at all, so we were guessing it was all engorged in the various cat-tissues in the chest cavity.
The vet confirmed that it was congestive heart failure, and reiterated how bad things were since we were now looking at multiple organ failure (due to his pre-existing decline into chronic renal failure)
We had a long talk about quality of life, and how far we ought to persue treatment. I tried very hard not to cry, and managed to keep the tears back and only croak like a frog twice.
The wait after that was awful.
I called around 6, but they had JUST finished the last of the tests, and the vet still needed to review the results. So, I called back again at 7.
His electrolyte levels were fine! The EKG showed some stress on the heart, but she said it wasn't anything more than she'd expect with all the congestion in his chest crowding the organ. Because of this, it meant it was safe to up his diuretic! That means we have another week (at least)
She said that if we can get the congestion under control, and get a clean X-Ray, we could manage the condition, and he could do ok for YEARS! We still need to get the fluid out of there, though. So, we doubled his diuretic, and I'm on day 3 of that. He doesn't like it, but he's tolerating it a little better every day.
Today, he's been more energetic.
The biggest problem right now is that Nugget has developed a REALLY bad habit of chasing him when he's in the hallway. Things like running are not good for him right now because we don't want him to have an elevated heart rate or stressors that would cause him to need to breathe harder. He just can't breathe harder yet. I suppose the upside is that the vet thinks it's congestion in the chest, and it's not the lungs. That means if we can get the fluid down, he'd be even more like his old self, and able to run around a little bit.
I really wish I could figure out how to curb Nugget's wild chase instincts, though. It's slowly been getting worse, and Senpu doesn't like to come out into the living room during the day if she's awake. I'm wondering if it would be a good idea to put a litterbox in the bedroom closet so maybe he'll go more often. I'm really mad at Nugget, but I'm no cat whisperer, so I dont' really know what I can do to prevent her behavior :/ Maybe I should call Jackson Galaxy!
Senpu goes back to the vet on Mon. If his Xrays still look bad, I don't know if there's anything else we can do. I mean, we could check electrolytes again and try upping the furosimide again if they're ok, but he gets so stressed and I don't want to get stuck in some cycle of freaking him out every few days. It's pretty stressful mostly because it's not black or white. It's not "he's ok," or "this really is his last vet visit," so it's frustrating. So.. Monday!