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16 March 2011

The Clan = U.S. Healthcare in Microcosm?

Malcolm
This is Malcolm. One of the nine cats I live with. He is also the latest victim in the ongoing medical saga of the Clan.

First there was Calvin, who was diagnosed with hyperthyroidism about this time last year, and now has to take meds for the rest of his life. Happily, after a rocky start, we've found the right dosage and he's doing fine. But, of course, he does have to take meds for the rest of his life.

Then there's Meggie. She came down with a bad case of constipation a few months ago. Apparently, when cats get constipation their colons never quite recover so she's taking laxatives. This isn't so bad, either. What it amounts to is that I put about a teaspoon of human laxative (Miralax) into a big spoonful of wet food and she eats it. I don't know what - if any - piquancy the Miralax gives to the food but Meggie likes it, and it's become the morning ritual that as soon as I put out the day's dry food for the other guys, she and I repair to the bathroom and she gets her bowl.

Emma was the next patient. She's been losing weight. If you know Emma, this is not a good thing because she's never been a very hefty cat. If cats were susceptible to anorexia or bulimia, she would be a good candidate to keep an eye on. As it turned out, her weight loss seems to be tied to very early stage II kidney disease. Because of her all the Clan is now on a kidney-friendly diet (supplied by the vet at twice the price of my old, pet-store-supplied food (sigh)).

And now there's Malcolm.

Last week I took him and Meggie in for their yearly physicals and rabies boosters. Meggie is doing very well but Malcolm had lost a lot of weight. Way too much for the vet's comfort zone. (He had been 15 lbs when I brought him in 2 months ago when I brought him in because he had a bad cold; when he was weighed this time he was down to 13 lbs. - too much loss too quickly.) The doctor did a complete blood/urine analysis, and it turns out that my little buddy has late stage II kidney disease. Unfortunately, that entails a bit more than just changing his diet; it means the vet put him on what's called "subcutaneous fluids." Twice a week, I need to put a saline IV into Malcolm. Shane, the vet tech, demonstrated last Saturday (March 12) when I was at the clinic. Yesterday (March 15 - "Beware the Ides of March" takes on a whole new meaning for Malcolm), I did it at home. It went very well. Malcolm was calm throughout and only got a bit fidgety at the end, squirming around and jumping away as soon as I pulled out the needle.

For those unfamiliar with the procedure: I take a bag of saline and hang it up from a high point. I take Malcolm and put him in the bottom of a cat carrier (it's close and makes it easier to control him). Then I pinch up a fold of skin, slide the IV needle in, open the drip and let c. 150ccs flow. It takes only a few minutes, and he develops this weird little camel-like hump of fluid. But - apparently - it helps the kidneys do their job, and if it makes him feel better then that's a plus as well.

This also is something that I'll have to do for the rest of his life (and more frequently as the disease progresses).

It struck me how much like the U.S. healthcare system my Clan is: An aging, largely uninsured or underinsured population (only 10% - i.e., me - has coverage) that's facing increasing medical costs.

It's probably not wise to push the analogy too far, though.

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