A Cat of Many Colors

                                    Ruthie is quite a cat.  More dog than cat really, at least behaviorally, she is named in honor of our adopted office mother, “Big Ruthie” Michael.

                        My first encounter with little Ruthie occurred at our reception desk one afternoon last fall.  A lady exited her car carrying a small bundle.  I recognized her as one of our clients who owns a Golden Retriever, but this was definitely not a large dog she was carrying.  As she walked through the door, the “mystery” was revealed---a tiny, longhaired, calico kitten with distinct copper eyes.

                        She found the kitten by the side of the highway.  Not knowing what to do, she brought it to our office.  “We’ll find her a home,” I exclaimed.  When Ruthie started to purr when I picked her up, I knew full well that I just had.

                        A recent near death run-in with a rat had put me on the recruiting trail for more barn cats.  I rationalized that this little fluff of multi-colored hair would grow up to be an ardent rodent killer and protector of my soul. Plus, there was something about this kitten that I liked.  Maybe it was because she liked me.

                        Ruthie spent the next few days in our office, building up her little body before beginning her new career in the barn.  She loved being petted and held, with those orange eyes staring down anyone in their path to do so.

                        Ruthie seemed to enjoy barn life.  She followed me around, albeit slowly, while I did my chores.  Once I found her in a pen of lambs being “schmoozed” by several at the same time.  I could tell she literally thought she was “the cat’s meow.”  However, it soon became evident something was not quite right with Ruthie.  She would have “spells” where she became very listless with some spittle on her chin, and at times even acted blind.  But, she always recovered and became “Ruthie” again.

                        One Sunday morning my wife came out to the barn.  A short time later I saw her leaving with Ruthie.

                        “Hey, where are you taking my cat?”  I heard her mutter something about “Ruthie’s not barn cat material.”

                        As much as she liked the barn, Ruthie enjoyed living in the house even more.  Being the center of attention apparently agreed with her.  Her “spells” became more frequent and dramatic, however, and usually occurred after she ate.  Often, ropes of saliva would dangle from her mouth.  This is called ptyalism and, unfortunately, it is a hallmark sign of a congenital liver condition called a portosystemic shunt.  And her “spells”---a fancy medical term for this is hepatoencephalopathy.  Also, these cats frequently have copper-colored eyes and are small in size.

                        One of our textbooks describes a portosystemic shunt as “an abnormal communication between the portal and systemic venous systems that allows intestinal blood to be delivered to the systemic circulation prior to hepatic detoxification.”  In English, this means that blood carrying digestive by-products, including ammonia from the breakdown of protein in her food, is not being filtered and cleansed by her liver, but is going directly to her brain. In essence, every time she eats, she poisons her brain with ammonia.

                        These shunts can be either extra-hepatic, meaning outside the liver, or intra-hepatic---inside the liver.  The treatment of choice for this condition is surgery, extra-hepatic shunts generally having a more favorable outcome.  My wife consulted a surgeon at Ohio State, one of our old teachers, and he told her the surgical success rate was only about 40% and that there still could be complications.

                        Not wanting to take that risk at this time, we are managing Ruthie’s condition medically, and she seems to be doing well.  She is eating a special diet, Hill’s Prescription Diet Feline L/D, formulated for liver problems.  She is also receiving lactulose, a sugar with laxative effects that increases the speed of ammonia removal through her colon, thus reducing the amount that reaches her brain.

                        Ruthie has grown into a beautiful cat, although we often call her “the third Border Collie.”  She races through the house and romps and wrestles with the “other” dogs at every opportunity. 

                        As I write this column, she is sitting on the edge of the paper on top of the kitchen table, staring at me with those orange eyes.  It’s hard to get mad at her though; she’s just being Ruthie.

                        I don’t know what the future holds for Ruthie, and that sometimes makes me sad.  Overall though, I’m alright with that, because I know we are fulfilling the only real need she ever had---to be loved.  That, she is.

Author:  Dr. John Jones