Desperate for any advice regarding my 17 year old cat and kidney issues/end of life stuff!!! - Mothering Forums
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#1 of 18 Old 01-19-2011, 06:14 AM - Thread Starter
 
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"Lady" is my 17 year old cat that means the world to me.  She represents so much in my life.  We went to college/grad school together, moved several times and she had been there through the death of both parents, the birth of both sons and the death of my beloved siamese cat last year.  There is little I wouldn't do for her.  In February of 2010, she was diagnosed with kidney failure.  Once a week....and sometimes twice a week we have been taking her in for fluids since then.  She also is on a daily kidney medicine.  I can't remember the name and I am typing this from work.  Since July she has pretty much had non-stop UTI.  We have been treating them with several antibiotics.  It seems that as soon as she is done with the cycle, the blood and peeing outside of the litter box comes back.  Her urine is so diluted that I would not notice the pee if it wasn't for the fact that she purposely does it in front of me.  In addition, she has lost a lot of weight over the past couple of years.  Every week she gets weighed and I jump for joy when she makes it past 5lbs4oz.  Generally speaking, she acts fine.  There are days when all she does is sleep and then there are days when she is sprinting around the house and jumping onto a 4ft counter without a problem.  She refuses to eat the kidney diet wet food, but will eat the Iams prescription kidney dry food along with tuna on a plate diluted with lots of water.  Mostly, she just drinks the water.  Recently, she was placed on Adequan (sp?) to help with the arthritis in her back.  She also gets bupronex (sp?) to elp with pain every 12 hours.  Sometimes I stretch it out to 16-24 hours.  Although....she does not act like she has arthritis at all.  We discovered the arthritis 6 months ago when she had an x-ray.  Our vets, whom I love, have said that they think she either has a bladder tumor or kidney stones and that is what is causing the UTIs.  I don't know what to think.  I have always said that I refuse to allow an animal to be in pain, but her case is not clear cut.  I know the UTI's are probably painful, but are they unbearable pain?  If it is something else, will the pain get worse and then we will know it is time to say goodbye?  Is it ok to keep doing what I am doing?  Am I hanging on for my sake?  What would you do?  Any thoughts?  Seriously..........I would appreciate any input.  I have gone through this in my head a million times and don't know what to say or do anymore.  My husband thinks Lady is losing her mind, and he might be right.  IS that a reason to put her down?  I love her with all of my heart and don't know what to do!  Please,Please.......any advice?  Thanks for taking the time to read this. 


Tricia, married to DH. 2MC's & 4 yrs ttc...finally mom to Andrew6/06 and Benjamin 10/09. Adopted bro & sis 2002. My 2 fav. words: Spay and Neuter! I'm an Ultimate Viewer, 2010!

 

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#2 of 18 Old 01-19-2011, 06:53 AM
 
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Sorry you are going through this tough time. The cat I grew up with (my mother's cat, but also mine) lived to be 22. I know all about a cat as a close family member.

 

From what you've said, I don't think it's time to put her down yet. It sounds like she sleeps a lot but is sometimes active. That says to me she is still enjoying life.

 

My 22 year old cat was having some issues, and he was also getting confused at the end of his life (not horribly so, but for example he might wake up and feel disoriented and start meowing really loud until someone came to him and then he'd feel better that he wasn't alone). He'd had a minor stroke at one point. It wasn't until the day that he'd had a major stroke that my mom put him down. His stroke was obvious and painful to watch (he staggered around and probably couldn't see anymore). My mother (and I don't blame her) wasn't able to just stand by and watch, so within 30 minutes of the stroke she drove him to the ER and had him put down (I wasn't living there at the time). I tell you this story to relate that what you've described is not that, not yet. You still have a happy cat. Your cat may have arthritis and such, and she may even be getting a bit confused, but she's still herself.

 

We humans have the urge to act. When it's a person going through this stuff, we don't have the urge to euthanize them but we do take them to the hospital, etc. But obviously the hospital isn't the same for cats (for end of life - I'm not talking about surgery or similar treatments for an otherwise hale cat). They will be lonely and scared. They should be at home. But we feel this urge to DO something, and all we can really DO is euthanize them. I understand that urge, but I think it's still waiting time. I've written this without a thought to finances and such. Blessings to your cat.


Homeschooling mama to 6 year old DD.

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#3 of 18 Old 01-19-2011, 11:40 AM
 
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OP - you have my sympathies.  We went through a similar situation with our 16 yo old Siamese last fall.  Her chief issue was diabetis but toward the end, her kidneys started to fall and she experienced the same urination issues.  Rivers and rivers of urine outsite the box.

 

We started taking her in for fluids and that was sort of the beginning of the end.  I just couldn't continue that, she was miserable in the car, terrified at the vet and overall it was just too much for all of us.  My vet did mention that she has several owners that have brought their cats in for fluids for very long periods of time so if that is working for you, great. 

 

If she seems to be enjoying life then I don't see anything wrong with continuing with what you are doing. 

 

We keep our C. around longer than we should have, we did it for us, not her.  Looking back on it, I can pinpoint when she no longer seemed happy and reasonably healthy yet we kept up the constant vet visits, adjusting medications, etc.

 

Towards the end, the vet sat me down for "the talk" and helped me see the light.  She (the vet) said future measures would not improve C's life, only prolong it.  The vet gave me a wonderful handout that outlined signs to look for and tips for helping owners make the decision.  Sadly, DH threw it away in a grief-stricken state so I can't post it.

 

When did I know it was time?  She started just staring off into space, she stopped reacting to our voices.  She no longer got pleasure from cuddles and scratches.  She stopped purring.  She became very unsteady on her feet.  She stopped grooming herself.  The final sign for me was the morning I watched her try to take a drink of water and she could only manage to dip her face in the water, that is when I made the call to the vet.

 

I will share that my DH was in complete denile.  He was truding ahead under the assumption that one day, she would just magically get better.  I very much felt like the bad guy.  I had to force the issue and make the appointment.  I resented the fact that he refused to participate in any decisions.   Weeks afterward, he admitted that he needed me to push forward and make the call, then he emotionally could not handle it. 

 

If you want her to remain at home and are worried about pain, ask the vet if you can have strong pain killers to administer at home.  We made the decision to stop insulin and all other treatments the Thursday before Labor Day.  Added to that, we were going to be at our cottage, a 90 minute drive from the vet.  Our vet gave us liquid pain meds, pre-measured in oral dispensers and told me when and how to administer them if she seemed in pain.   It didn't come to that (she seemed rather comfy over those days, a final rally of sorts) but I liked knowing we had meds on hand if needed.

 


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#4 of 18 Old 01-19-2011, 11:41 AM
 
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Originally Posted by gumby74 View Post

She refuses to eat the kidney diet wet food, but will eat the Iams prescription kidney dry food along with tuna on a plate diluted with lots of water.  Mostly, she just drinks the water.


It's a heavy trip, to be sure. I had to summon the vet for my 19-year-old the Tuesday before Thanksgiving two years ago, and I still wonder if I waited one day too long. It doesn't sound like yours is there yet, though, if she's still having good active days, and I suspect the vets would let you know if you were prolonging a very painful situation for the cat.

 

CRF can often be successfully managed for years. There are a couple practical things I would suggest: It sounds like you're already burdened with giving a fair amount of meds, but you can learn to administer sub-Q fluids at home if you want. It scared the devil out of me, but I eventually became reasonably competent, and it avoids hauling the cat to and from the vet. On the food, it's probably best to keep trying to get her on a wet diet (although adequate calories are the most important thing). My vets at the time carried Purina NF, Hill's k/d (regular and minced), and Eukanuba/Iams Multi-Stage. I got nowhere with anything but the k/d minced, and he would get burned out on it. I then came across a mention of Royal Canin Renal LP pouches on a CRF forum, convinced the vet to special-order some, and it really made all the difference in keeping weight on him. The stuff is stinky. Alternating this and the k/d minced at meals allowed us to put and keep a pound on him, and despite blindness due to a retinal detachment, he kept active and trying to stage escapes into the park until the very last month.

 

As long as she's generally acting fine, I'd take her actions for her words. You'll know. She's fortunate to have found such a caring person to travel through life with.

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#5 of 18 Old 01-19-2011, 11:59 AM
 
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She refuses to eat the kidney diet wet food, but will eat the Iams prescription kidney dry food along with tuna on a plate diluted with lots of water.  Mostly, she just drinks the water.


CRF can often be successfully managed for years. There are a couple practical things I would suggest: It sounds like you're already burdened with giving a fair amount of meds, but you can learn to administer sub-Q fluids at home if you want. It scared the devil out of me, but I eventually became reasonably competent, and it avoids hauling the cat to and from the vet.

 

As long as she's generally acting fine, I'd take her actions for her words. You'll know. She's fortunate to have found such a caring person to travel through life with.


Good suggestion.  My cousin did the fluids for one of her cats at home for years.  The vet assured me I could do it myself but C. had too many other issues going so I didn't explore that option.

 

the last sentence is excellent :)
 


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#6 of 18 Old 01-20-2011, 06:51 PM - Thread Starter
 
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 Thank you, thank you for the responses!  The more I read, the more I agree that she is not at the end,yet.  I think that Laohaire was right on about humans feeling like we have to DO something.  At least that is how I feel.  I don't want her to suffer at all and am always watching every little movement and action to see if she is showing more signs.  I know I'm driving myself crazy about it, but it's because I love her so much.  Keeping her from pain is the least I can do for all she has added to my life.  

 

Otto:  I don't think I can get myself to do the fluids at home, but it might come to that.  It can be a pain to take her in, but I kind of like the fact that they check her out each time and weigh her.  She seems to be ok with the ride, etc.  The Royal canin food is what we were giving her until they started selling it only in cans and the formula changed.  It was the only kidney wet food she would eat.  Any idea where I can get it? 

 

Do you think it's ok for me to just continue to keep her on pain meds for the UTI and arthritis issues?  The vets have told me that I could do a ultrasound on her, but that would require shaving her/sedating her.  I just don't want to put her through it.  Plus, I am a little worried she wouldn't survive the sedation.  Another part of me is thinking that if I did and we found a tumor or kidney stones that there is probably little they could do because of her age and then I am left to just worry more.  Ugghhhh too many thoughts!

 

 

 

 

Thanks again everyone.  love.gif


Tricia, married to DH. 2MC's & 4 yrs ttc...finally mom to Andrew6/06 and Benjamin 10/09. Adopted bro & sis 2002. My 2 fav. words: Spay and Neuter! I'm an Ultimate Viewer, 2010!

 

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#7 of 18 Old 01-20-2011, 07:41 PM
 
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The Royal canin food is what we were giving her until they started selling it only in cans and the formula changed.  It was the only kidney wet food she would eat.  Any idea where I can get it?


Oh, no, I hope they didn't screw this up just for the sake of putting 2.5 oz in a can instead of 3 oz in a pouch.

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#8 of 18 Old 01-22-2011, 01:47 PM
 
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Alpha Omega (I sound like a rep by the amount of recommending I do), has a kidney flush that treats UTIs, and breaks up kidney stones.

I've used their products on me, kid, dogs and horses.  I'd use the products for my cat too if she needed any.

 

Its a reputable company with good products. They have a website, just google 'Alpha Omega'.

 

Is it possible your cat has cushings or diabetes?

 

BTW- giving fluids is so much easier than you may think. I can give them sub-cutaneous, IV or IM. It was a relatively easy skill to pick up.


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#9 of 18 Old 01-22-2011, 01:49 PM
 
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Well it won't let me edit- I forgot to put in, how is her thyroid functioning?


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#10 of 18 Old 01-22-2011, 02:07 PM
 
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Sorry to read about your cat. I just discovered that my cat is also in renal failure. She is 14 years old. Currently, she has no symptoms other than weight loss, drinking lots of water, and being slightly grumpier than usual. I am very sad about it, but I have decided to take no heroic measures. The vet said that I could do the fluid thing, but he did not seem optimistic about it.

Besides, I can't afford to do it.

 

I have decided that when her quality of life declines to the point where she is no longer feeling well I will take her in and have her euthanized. It is a tough decision, and I will be very sad to do it, but I can't bear to see her suffer just to keep her around.

 

It sounds to me as though your cat still has quality of life, and that is what matters. Good luck to you.hug2.gif


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#11 of 18 Old 01-22-2011, 03:49 PM
 
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The vet said that I could do the fluid thing, but he did not seem optimistic about it. Besides, I can't afford to do it.


I completely respect that you are the only one that can truly guide and assess your cat's quality of life. But I still feel compelled to note that home sub-Q isn't necessarily expensive, in case anyone else is considering it. A case of Ringer's bags (12 liters, ~80 doses) goes for about $25, and needles are a dime.

 

[ETA.--Order-of-magnitude error in the number of doses corrected.]

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The vet said that I could do the fluid thing, but he did not seem optimistic about it. Besides, I can't afford to do it.


I completely respect that you are the only one that can truly guide and assess your cat's quality of life. But I still feel compelled to note that home sub-Q isn't necessarily expensive, in case anyone else is considering it. A case of Ringer's bags (12 liters, ~80 doses) goes for about $25, and needles are a dime.

 

[ETA.--Order-of-magnitude error in the number of doses corrected.]

 

I would just like to add that in addition to the cost, there is no way my cat would allow me to stick a needle in her, I would have to sedate her somehow. She is just not that compliant. She has claws, and she knows how to use them. When I took her to the vet, she freaked out and jumped off the table, hissing and yowling,  after he poked and prodded at her. She then scratched me pretty good... She is somewhat wild, always has been. Maybe due to the tabby in her????
 


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#13 of 18 Old 01-23-2011, 01:25 PM - Thread Starter
 
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Hello again....we know that her thyroid is hyper, but we can't give her the meds because the last time we did, she had a very bad reaction.  I believe the last time she had a blood test/urinanalysis....no real signs of diabetes. 

 

Thanks for the website suggestion.  I'm definitely going to look that up!  Have I mentioned that the Mothering forums have the smartest people?  love.gif


Tricia, married to DH. 2MC's & 4 yrs ttc...finally mom to Andrew6/06 and Benjamin 10/09. Adopted bro & sis 2002. My 2 fav. words: Spay and Neuter! I'm an Ultimate Viewer, 2010!

 

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#14 of 18 Old 01-23-2011, 05:47 PM
 
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So here is something new I recently learned: goats milk is easy to digest for all animals and good for weight gain. You could mix powdered goats milk into her food, or get fresh/store bought and let her drink it.

I have heard of people using it for horses, nursing babies (of the animal variety), and bitches that are pregnant or lactating who need to keep their weight up. Maybe it would be good for your cat?

 

I remember using goats milk for abandoned baby bunnies, and they all lived.


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#15 of 18 Old 01-24-2011, 02:26 AM
 
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So here is something new I recently learned: goats milk is easy to digest for all animals and good for weight gain. You could mix powdered goats milk into her food, or get fresh/store bought and let her drink it.

 

What's the phosphorus content?

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#16 of 18 Old 01-24-2011, 09:49 AM
 
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I cannot comment on any of those foods, but raw green tripe is recommended for dogs with later stage kidney disease because of its low protein/phosphorus content. I often feed it to my very healthy but fast growing mastiff pup, cos he really loves it, I assume it tastes and smells great (to him). You can buy it in ground form from Hare Today which would be easy for an old cat to manage.


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#17 of 18 Old 01-25-2011, 08:38 AM
 
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Dude, I;m so sorry, but I would say it's time to let her go.  Kidney failure is progressive, and it sounds like her body is losing the battle (multiple uti's, dilute urine).  The blessing is that we CAN end their pain and give them a dignified ending, surrounded by their loved ones.  Hugs

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#18 of 18 Old 01-28-2011, 02:13 PM
 
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My elderly cat also had kidney failure.  I joined a wonderful Yahoo group, where there's so much great info and shared wisdom about this. 

 

http://pets.groups.yahoo.com/group/Feline-CRF-Support/?yguid=335525947

 

There even ended up being an amazing lady who had recently lost her beloved cat to kidney failure, but still had a lot of the supplies on hand... including the fluids and needles etc.  She lived near me, and offered these to me... and also ended up dropping by every day during my cat's final times to administer the fluids for me... free of charge. (she was a nurse too, so pretty good at it)

 

If your cat is still happy and playful and eating enough to retain weight (even with some encouragement- some cats will eat food from a syringe or eye dropper on your lap or something, when they won't from a bowl, or off your finger), then I would say she still has quality of life.  This is what you need to assess.  Sleeping a lot is fine- in fact good, as it helps the cat to keep in as good shape as possible- and cats sleep the majority of the day anyway.  A cat will let you know when it is no longer enjoying its life... it becomes very obvious.  Withdrawn and unresponsive in usual way to your attentions, not eating much if any, not playing or moving around much etc.

 

It's very important to try to make sure she is drinking enough (along with the IV fluids)... some cats like to drink from a dripping tap or water feature... sometimes a bowl raised up to chin sort of height makes it easier.  This also applies to food, as cats with this condition cat get reflux, and it's worse when they have to hang their head down to eat, so they avoid it more.

 

You certainly can do the fluids at home, depending on your cats demeanor.  Mine was an angel.  And I tend to think it's less stressful for them at home.

 

Oh, and as for losing her mind... I believe that can happen, but if your cat is still happy and it isn't distressing her overly, it's probably just one of those things you deal with when your cat is elderly and ill... probably not something to be overly stressed about at this stage.

 

As for the UTI pain or any other concerns... I guess only you, knowing her so well, can assess how she is doing with these, along with taking into consideration what the vet says.  But, you see her all the time, the vet only sees her under stress for a short time... you are probably better able to judge how she is coping.

 

Unfortunately, although cats with this condition can survive reasonably healthily for a time (mine for a couple of years or so, my sister's had it for a few) eventually there will come a time when you will have to make that final decision for her.  And please don't let that decision be put off after you know it really should be made... I know first hand how hard it is, but once their quality of life is so low, it's only for ourselves we are keeping them here longer.

 

I urge you to join that yahoo group I mentioned and take advantage of such a wide pool of knowledge.  they have links to some other wonderful resources too.  And I'm sure they will be able to help you recognise when the time is here.

 

You have my greatest sympathy for what you are going through.  It's a torment.  But try to enjoy each day you have left with her.  My thoughts will be with you both.

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