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Hello - I am Dr. Matt - Sorry to hear about your traumatic experience. Is he drinking normally? Does he seem to be swallowing normally?
Is he having any labored breathing?
Hi, thanks, XXXXX XXXXX eating and drinking just fine, and swallowing is also fine. His breathing also seems ok: the rate is normal, and there is no cough. He is purring fine too :) I checked his exercise tolerance because he seemed so subdued, and he chased a toy mouse just fine, did not get tired out. So he seems fine except for the voice change and the subdued behavior.
I forgot to add: the vet also tried to palpate his thyroid and did extend our cat's neck quite a bit for the blood draw-attempt.
she also attempted a cystocentesis, but it was not successful either (got a small amount of urine on try # XXXXX then no urine on 2nd try so gave up).
There is a chance that if he moved very quickly to one side that a needle could have accidently penetrated the trachea or larynx area which could cause a sudden change in his voice. He definitely could have been crying so loudly though that he has some laryngitis. I am sure your vet would have told you if she suspected that the needle went into his larynx.
Does your vet have a technician or an assistant that can restrain him for you?
I was worried about the needle possibly injuring one of the laryngeal nerves, could that account for his losing the upper range of his voice?
She doesn't have an assistant because she does house call service. We liked having her come to our house so our 2 cats doen't get so stressed out, but now I'm wondering if I should have taken him into a vet clinic instead...
The extension of the neck should not have caused much of a problem or the palpation of the thyroid glands. I would be more concerned with the other two possibilities. Good question about the laryngeal nerves. I would expect many more problems if I nerve was severed, but a slight injury to the nerve can cause a change in voice. This is not commonly reported in cats though is possible in people. I would expect this to be similar in cats as the nerve has the same functions basically.
Is there a way to distinguish between laryngitis versus nerve injury? (He is not hoarse, just lower -pitched meow, and murmuring instead of chirruping now)
Ok - I can understand that. In this case you were doing the best for your cats by trying to reduce any stress. If he is hard to restrain, you may want to either try to take him to a clinic with an assistant to help and consider drawing blood out of a vein in his back leg which most cats seem to be much more easy going about. This is where I draw the blood in all cats, though this requires a trained assistant to help hold. You may even want to consider a quick but safe sedative if restraint is not going well, because the bloodwork is very important to make sure he is overally very healthy.
sorry my internet cut out, I had typed a response but unfortunately it never went through - let me retype what I had said.
A laryngeal nerve injury usually can last up to 3-4 weeks to completely heal. Laryngitis or an injury to the airway should only last 4-5 days at the most. The only other way to find a nerve injury is to have an MRI performed. I do not think this is necessary due to the fact that all of the other symptoms that you are describing are normal.
Is there a good chance for complete recovery then?
Definitely, I think no matter what happened, he should be able to get his voice back.
Oh that is good :))
Which do you think is more likely from his symptoms, laryngitis or nerve injury ?
I would say laryngitis.
if he is not better in a week or so, would we then need to get him evaluated for the possibiltiy of nerve injry? or just wait and watch?
At that time the answer would be up to you. As long as he is eating normally, swallowing normal, and not having any breathing problems an MRI is not worth putting him through. To have an MRI in a cat, general anesthesia is needed therefore posing a risk for him. Unfortunately, even if you did find out that he has an injured nerve the only true treatment is going to be to give this nerve time to heal. Therefore, time will be the best treatment and answer for him. Either way his prognosis is very good.
Thanks so much for all your help-- so do you advise us to avoid the jugular blood draw next time we try it ?
That is what I would do in this situation, but to draw blood from the back leg, she will need an assistant to hold him as this is much harder to get a larger sample.
Ok, thank you... do you have any other advice?
Cats are funny when it comes to restraint, even though some will do well with their owners holding them I generally recommend having an assistant hold them so you do not have to feel bad about the situation. You did nothing wrong, and either did he - I would flail if I did not understand why someone was poking my neck also. I guess with him see if the vet can have a technician come with her, or call a vet that does do house calls with an assistant to help you.
Yes I agree, I would like to have a tech present for the next attempt. Is there any consensus among vets as to when to do the jugular vein draw, versus the back leg? I would like to go for the least risk, and the best chance to have a successful blood-test (with enough blood to get the needed values assessed)
There really is no consensus to what is better. The place to draw blood completely depends on the vet and where they are most comfortable performing the blood draw. The jugular vein is the best place to get a larger sample, but in cats that do not hold the neck very still I find that I can get just as large of a sample from the back leg because the cats find this less intimidating. Overall I would say wherever the vet is most skilled is the best place to have the blood draw.
That is good ... I guess we will need to discuss options with our vet, in terms of finding a tech, and also, whether she could do the back leg access, which I would definitely be more comfortable with. (She had advised against it due to difficulty getting enough blood) Is that true that it is harder to get an adequate sample from back leg?
Generally speaking, yes it is harder to get as large of a sample, because the back leg takes much longer to get a sample due to the smaller vein. We also use a smaller needle on the back leg which also makes the blood flow slower. With the right amount of patience and skill though, my techs and I can usually get more than enough blood from the back leg. She most likely wanted to try the neck because the back leg requires a specific type of hold to position cats to get enough blood.
Right. how long should we wait before retrying the blood test? Should we wait until he has recovered his voice?
If he is otherwise not having any symptoms of sickness you can give him a couple of weeks before retrying. If you want to try sooner though for example in a few days there is no reason why you cannot do this.
ok . Thankyou so much for answering all of our questions and in such great detail, We really appreciate your help !
We haven't used the service before, can you tell us, is there a way to access our chat again for future reference?
You are very welcome! I hope that second try is much more successful. Yes you can always go to your account and look at the question. Every word will be listed as we typed it on the page for you after you accept and the chat is closed out.
Ok- great. Thanks again very much. We just noticed we will be your 100th Accept :-)
thanks for everything!
Time to celebrate!! Thanks in advance
thanks again and good night !