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My 14-year-old cat, Bella, seemed like she'd lost a little weight a couple months ago, so the vet ran some bloodwork. We noticed her calcium was high, which he thought might be a fluke, so he asked us to wait a few weeks and come back. Her bloodwork this time was unmistakeable -- it's her kidneys, and he said it had advanced to stage III. My husband and I both knew the bloodwork this round was going to be bad -- she hasn't been herself lately. She sleeps heavily, sometimes needed to be coaxed towards mealtime (before, she'd come running). Her breath has gotten strangely bad. She's lethargic and not her usual self. I asked the vet how long and he said he doesn't like thinking about tomorrow, that we should focus on today, that she's groggy but more-or-less herself and seems happy, if sick, and we should just monitor that. I don't know how fastly this is going to progress. I don't know how much time we have left. I am trying so hard to write this informatively and ask coherent questions when all I want to do is burst into tears and tell all of you that Bella is my tiny fluffy angel and she isn't allowed to be sick and I don't know how to handle any of this, but I'm just barely keeping it together at this point. I'm 36 years old and she's the first pet I've ever owned, so I've never gone through this. I guess any information would be helpful. About Bella, because I feel like writing about her: she was rescued at around six months old, and was terrified of the world for most of the next year, and then blossomed into the cuddliest lapcat ever. She's curled up with me as I write this now, having thoroughly snubbed the kidney food the vet gave us. She keeps resting her chin on my hands, thus making it hard to type.   Advice, information, anything at all would be helpful. Or even if you just want to tell me that she looks like the fluffiest, softest kitty ever, because she is.
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Oct 25, 2014 00:58
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| # ? May 14, 2024 14:42 |
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There are things you can do to help her to feel better - I mean it's kidney disease, it's going to progress, but with dietary management +/- subcutaneous fluids and other medications to help her she can remain comfortable for awhile. It's kind of weird that these bloodwork changes would have happened over the course of a few months though - the stage designation you're hearing is for chronic kidney disease.
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Oct 25, 2014 02:36
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I've been there, and don't mind writing a big ol post about it. My cat was diagnosed with CKD at the end of May. She's 11, and doing really well now, but was probably days from dying (without treatment) when I took her into the vet.  Here's Adee. Back in May she started throwing up frothy foam and her food increasingly frequently, lost weight, had horrible breath, was listless, and then stopped eating entirely. In retrospect she'd had symptoms for at least a year and I felt horrible for not taking her in sooner. We rolled up to the vet, got some quick bloodwork done, and it was really bad. Creatinine 12.0, and BUN >135 (off the chart for the machine). She got sent straight to the emergency vet hospital for IV fluids and 24 hour care, and stayed on the IV for four days. They ran other tests to look for an underlying cause but the result of that was just that her kidneys are abnormal. IV fluids took her creatinine levels down to 4.1 and BUN to low 50's, I think, and I took her home along with a bag of Plasma-lyte and instructions on giving subcutaneous (subq) fluids. She got 200 ml every other day for a week and since then has been on 100 ml every other day. Subq fluids continue to help. A month out her creatinine dropped to 2.8, and just last week it measured 2.2, which is barely abnormal. Now the vet is working with us to see if we can reduce the fluids a little without things getting worse. Online stuff: The best guide online I've found is Tanya's guide, which looks late '90s as hell but is up to date and a really comprehensive site from an owner's perspective. It agrees with what I've heard from the vet, and has lots of things to learn and ask about. There's also the IRIS website, which is the group that decides what "stage III" means, but it's mostly technical information for vets. It does have some fairly accessible information on how staging works, and that you often don't get a good idea until the cat stabilizes after a month or two of treatment. There's also this page with nice tips on giving subq fluids, featuring a cat that looks quite like yours. Food: It is very important to keep your cat eating, as bad things happen fast when cats don't eat. One of the prescription diets, ideally. Mine eats the purina prescription kidney diet very well, even prefers it to her old food, but we kept her on the old food until she was feeling much better from fluid therapy and had an appetite again. If cat refuses the prescription diet it then giving a relatively low-phosphorous food that cat will eat is the next option, and maybe adding a phosphorous binder from the vet. Here's a big list with manufacturer-reported phosphorous levels assembled by a vet, and Tanya's (scroll to the bottom) has lists ordered by lowest amount. Food for CKD cats goes somewhat against the main food thread in here, as the high grade, high-protein foods are hard on the kidneys, apparently. Wet is very much best, as the cat needs as much fluids as they can absorb to flush out the stuff that makes them feel bad. Mine hates all canned food, but I pour some water on her dry to get that little extra bit of fluids into her. I also put out some extra water bowls around the house. Fluids: This is the main treatment as I understand, and is instrumental in helping the cat feel better, thus eat. Failing kidneys doesn't hurt in itself, apparently, but all the junk that's not filtered out as effectively is what makes the cat feel bad and act sick. I really encourage you to read some of the stuff on fluid therapy on Tanya's website, and talk to your vet about it. Giving the cat subcutaneous fluids at home is more common in the US than elsewhere in the world, as I understand, but if your cat is stage III that's when IRIS calls for IV or subq fluid treatment. I would go back to the vet waving a printout of the IRIS treatment recommendations. If your cat's not eating, things can get very ugly very fast. Since she started getting regular fluids, my Adee's been acting years younger, she's grooming herself and playing more, gained back the weight she lost, and naps out in the open rather than hiding. It's been a really amazing improvement, and I hope your cat gets treatment and responds at least as well.
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Oct 26, 2014 00:43
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UPDATE of sorts. Bella's doing much better. She's actually acting like herself again -- her eyes are bright, she scampers, she cuddles. Every now and then you can tell she's not 100%, but she's a completely different cat than she was two days ago, when the pink edge of her nose looked so gray. I forgot to mention this in my original post, but both of you brought up subcutaneous fluids: she's on those currently, and I'm convinced that's the reason she's made such a turnaround. Since I've been doing some research online, I've seen other people online say that they needed to argue with their vets to be able to administer fluids at home, but it wasn't even a discussion -- our vet said "here, this bag will go home with you, give it to her once a day, we'll show you how." (it's the Lactated Ringer's, which is apparently a good thing.) I'm not sure how her bloodwork jumped so abruptly, but it did. The vet went over the results with us line-by-line both times; last round, in late August, the only thing abnormal was her calcium. Creatinine and BUN and WBC and all the rest were solidly in the normal range. He said the calcium could either be a fluke because of her weight loss or a sign of something worse that hadn't cropped up yet. When we came back for the next round of blood work, she'd lost another half pound (down to 4 1/2, scary) and this time it seemed like everything was off the charts. We've also been given special kidney food, which my husband discovered she's more likely to try if it's warmed up some. She also is the cat who will attack your plate the second you get up to refill your drink, so I asked the vet whether human-grade food is okay for her, considering her kidneys and all. His response was that anything to get her to eat at this point is good. So she's a little cranky that she's not getting the same food as the other kitties, but she's got an appetite, and I've been feeding her anything she gets excited about and tries to swipe from me -- a meatball, some bits of sausage, pepperoni. She gets so happy when she noms down on those. It's adorable. (I know, I know, I should be trying to encourage her to eat the kidney diet food, and I am, but again: 4 1/2 pounds, so anything she actually wants to eat is A+ at this point.) topographic what you went through sounds terrifying. Bella didn't actually bottom out, thank goodness -- we just happened to notice while petting her that her spine felt like it was sticking out. (Which worries me, because a bony spine is supposed to be a very late-stage sort of Bad Sign from everything I've seen online, but maybe it's extra-noticeable on her because she's always been a tiny cat.) That was when we got the mostly-normal bloodwork. We made a follow-up appointment, and in the interim, she got lethargic, her breath started reeking, and she became less and less responsive. We've also started putting out extra water dishes -- and extra litter boxes, as the fluids are causing Bella to have accidents all over. Apparently that's pretty normal, too, since she's not used to being hydrated. Pee washes out, no big deal. I think I've been terrified and viewing this as a very short-term sort of thing -- she's in stage III, who knows how many days or weeks she has left. But you're saying Adee's been going strong since May, and that one page you linked said Sophia lived for another 14 months, and those are both hugely reassuring right now. It's easier to think of this as managing a chronic illness; I was worried that such a quick progression from "nothing weird" to "Stage III" meant a similar dip was coming to Stage IV, but she's got meds and fluids, so it's not exactly the same situation. I am bookmarking those sites, thank you so much. Especially Tanya's, that one is amazing. And by the way, Adee looks so adorable and nuzzle-able and I'm so glad she's doing better. Thank you both for writing. It helps knowing that other people have been there.
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Oct 26, 2014 10:05
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I'm glad Bella is improving with the fluids, they really do help. It sounds like you're doing all the right things  As to food, I agree, eating anything at this point is great, and means she is feeling better. And thanks for your kind words about Adee, it was super scary but she's doing really well now and I nearly have the carecredit bill paid off, haha. It sounds like vet is on the ball with treatment and figuring out what's going on. I wouldn't worry too much about the numbers and staging for a while, it seems common (and was my experience with Adee) that cats with CKD get diagnosed when something like a UTI throws their system out of whack and they get real sick, with a corresponding big change in bloodwork. Then, if it's caught and treated in time things slowly improve to the new normal. My vet calls this "acute on chronic" and it mainly means you gotta be quick to go in to the vet if something seems off or getting worse, especially vomiting.
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Oct 26, 2014 16:42
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My sister's cat (also named Bella) passed away this year from this. Fluids are a HUGE help and will keep her comfortable and lively. Sounds like you're on the right track with the special diet (and treats) as well. Keep on with what you're doing and spoil her rotten. I'm going through something similar; caring for an older cat who is the first pet that's ever been totally "mine". Good luck with everything.
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Oct 26, 2014 19:52
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spacing in vienna posted:I'm not sure how her bloodwork jumped so abruptly, but it did. The vet went over the results with us line-by-line both times; last round, in late August, the only thing abnormal was her calcium. Creatinine and BUN and WBC and all the rest were solidly in the normal range. One of the vets may correct/elaborate but my understanding is that is what happens every time. Creatinine doesn't show up at all until the kidneys have lost approximately 75% of their function, and then builds up fast.
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Oct 26, 2014 21:44
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Slugworth posted:One of the vets may correct/elaborate but my understanding is that is what happens every time. Creatinine doesn't show up at all until the kidneys have lost approximately 75% of their function, and then builds up fast. What I was getting at with the comment that I made was that there may have also been a component of dehydration to the numbers so they may actually go down a little with good management and it may stabilize at stage II.
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Oct 30, 2014 05:01
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Thanks for the update; I just posted a thread about the same thing. We discovered my cat is Stage II after she had two sudden seizures (they are checking for bladder infections that could falsely inflate the numbers, but I'm going ahead and assuming it is truly Stage II). She's on k/d and is absolutely SCARFING it down. I've been trying to ease her on it by mixing it with her previous food (Freshpet nuggets) and she picks around the nuggets and just eats the k/d food. The vet said since cat treats aren't the best for her, I could cook some plain chicken breast and give that to her for treats. This will be especially handy when I start doing subcutaneous fluids this weekend (we had her first one yesterday at the vet and she did not enjoy it, but the room was cold and I'm sure the water was too, so maybe it'll be better at home, though I'm nervous about doing it). The vet tech said the resident cats at the vet hospital come running for subcutaneous fluids because they know it'll make them feel better, and they'll get treats. Now I'm one of those crazy people who buys better food for their cat than themselves; she gets the expensive plain chicken breasts while we get the stuff that's been injected with salt and marinated in preservatives. Worth every penny. If I may ask, how hard was it to get the hang of the sub-q fluids? I thought I'd be able to handle it but the needle gauge is rather large and I'm not looking forward to doing it myself the first few times. I'm glad your beautiful Bella is doing better. My vet said with proper nutrition and subcutaneous fluids, it's not uncommon to get another 4-5 good years. And when the disease progresses, it happens fairly fast, so there's not going to be a prolonged period of suffering. Truthfully, with a 14 year old cat, you have a lot to be thankful for. I'm sorry if that sounds flippant, but I'm trying to be optimistic here for both our sakes.
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Oct 30, 2014 06:07
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Seconding/thirding the Tanya's guide thing. I also highly recommend joining Tanya's CKD support group and posting your labs there. They offer pretty good advice. I've gotten my cat's Creatine to under 3.0 after picking a food low in Phosphorus labeled on that website.
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Oct 30, 2014 07:45
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Thanks again to everyone posting, with all of the info. Bella's really seeming like herself again, although she's clingier than usual. I'm sure it's me being way too optimistic, but I even think her spine is less bony. Maybe she's already put on a little weight. I can dream, can't I?skaboomizzy posted:My sister's cat (also named Bella) passed away this year from this. Fluids are a HUGE help and will keep her comfortable and lively. Sounds like you're on the right track with the special diet (and treats) as well. Keep on with what you're doing and spoil her rotten. I'm going through something similar; caring for an older cat who is the first pet that's ever been totally "mine". Good luck with everything. A sad thing for us to have in common; I hope your kitty is doing better, too. And I'm sorry about your sister's Bella. "Spoil her rotten" has been our mantra all along, for her as well as the other three. I mean, that's the whole point of having kitties, right? Topoisomerase posted:What I was getting at with the comment that I made was that there may have also been a component of dehydration to the numbers so they may actually go down a little with good management and it may stabilize at stage II. Fingers crossed on that. And she must have been seriously dehydrated, considering she spent the first day peeing out most of the fluids we got in her. We've got extra litter boxes out and that seems to be helping with the accidents she was having. Maggie Fletcher posted:(lots of words and some questions) Weird, my vet didn't mention cat treats being a no-go. It may be that her numbers are different, or maybe with Bella the critically-underweight issue is bigger than her kidneys right now, and any road to plumping her up is a good one. The sub-q fluids we've been doing about a week, now. I feel like we've got the hang of it, so long as Bella actually cooperates. She's started to figure out that when the bag comes out, it's Needle Time, and begins to squirm and try to make a break for it. The hardest part, honestly, is getting her to hold still. The first time or two, it's awkward and you're convinced that you're maiming your poor kitty with the needle of doom, and then after that it's just DAMMIT CAT HOLD STILL ALREADY. Fair warning, the first time we managed to get fluids everywhere, I poked myself with the needle, and the line only stayed in for maybe thirty seconds before kitty bolted, soooooo if your first time is similarly a clusterfuck, do not be discouraged. It's been much smoother ever since. (Granted, we have two people, one to jab and the other to hold kitty in place.) A trick my husband came up with: when you pull up the loose skin into a tent, on the back of her neck, try sliding the needle in along the fold, nice and quick. Also, I don't know how many ML you're giving her, but it generally only takes a couple of minutes to get the fluids in. We feed her treats to try to get her to stay calm, but she's losing patience with the pincushion treatment. Luckily, she doesn't seem to hold a grudge, and will clamber onto my lap five minutes later. We also have been very "know when to hold em, know when to fold em" about it. The first night, when we got very little in and she fled -- hey, some is better than none, let's wrap it up and try again tomorrow. The other night we almost didn't manage it at all, because she was very upset and squirmy and wanted NOTHING to do with us, and we took five minutes to try to calm her down enough to try again. It worked, but our option B would have been "abort mission, retry tomorrow." If it had been six nights of fluids this week instead of seven, that's still a lot more than she was getting before we took her in to the vet, and more importantly, it feels like taking a deep breath and not getting worked up about it really helps the process. And the last bit -- it doesn't seem flippant at all, to me. This is horrible to happen to any kitty, but she's fourteen, and we've had so many wonderful years together. I wouldn't wish this on any of my pets, but it'd be so much harder if this was the two-year-old squeaky cat that still thinks he's a kitten. And I'm so grateful that while she's sick, she's not in pain, like you said. It would be horrible if she was suffering and I couldn't stop it.
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Oct 30, 2014 11:12
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spacing in vienna posted:
Thanks so much for this! Yeah the treat thing was something I brought up and since Mona is at a healthy weight we can still be a bit picky. Everything I've read has said whatever you can get into her is good, even if it's not the most healthy thing. I'm just lucky that Mona loves her Rx food and prefers fresh chicken over everything else. Everything you've said about sub-q has lined up with what I've read and the vet advice, so I'm trying to mentally prepare myself for it. I do have a buddy to help me hold her, but I'm nervous about doing the jabbing myself. I'm not afraid of needles or anything but the actual act of breaking the skin with one myself is going to be tough. I'll definitely keep the "know when to fold 'em" attitude in mind. I'm giving her 100 mL 2x a week, and I have a 1L bag. I read that you're not supposed to keep the bag longer than 10 days, but my vet didn't say anything about that. What say you? So glad your girl is feeling better. With the right food and care, it wouldn't surprise me if she gains a bit.
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Oct 30, 2014 14:08
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I can't speak to your specific issue, I can only relate what I'm doing for my cat Washu. She is 17 and was getting increasingly frail. I've even had a couple threads about her Kidney deficiency and eating habits. Tanya's was a big help, and eventually we found the perfect kidney diet for her: whatever wet food she would eat. She was losing to much weight and was refusing all the kidney foods. Right now she is eating fancy feast beef and cheese feast (yuuuuuck) but is so much happier. Subcutaneous fluids are wonderful and were life changing for her as well. We've also gone out of our way to leave lots of fresh water around the house so she always has access. Is your cat still pooping ok? Our cat was not retaining enough water to poop and became chronically constipated. but a 1/4 tsp of Miralax mixed into her Catsip in the morning worked wonders and now she is pooping a lot better. 14 is younger than 17, and her health is a lot worse so I would definitely try to find a kidney food she likes..but don't feel bad if you just give her stuff she'll eat to pack some weight on. Sometimes that's more beneficial to kitty than a strict health regime. Good luck, what a beautiful catte!
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Oct 30, 2014 15:59
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Oh gently caress I wish I was updating this under better circumstances. It's not Bella, though. She's still ... trucking on, still hating the meds, still not gaining enough weight. One of our other kitties, Chase, a few days ago just started seeming -- not himself. He was a little sneezy and a little odd, so we decided we'd take him to the vet Monday morning. Better safe than sorry. A few hours ago, he was just -- lying on the ground wheezing, barely responsive, so we scooped him up and sped the whole way to the animal hospital. He didn't even make it there. He stopped breathing in my arms. None of this seems real and everything hurts and I don't understand and how, how did I not know he was sick? How did I not realize it was serious? I sat in the car and sobbed and begged him to just keep breathing, for me, and wishing we could speed through red lights. I've never lost a pet before. I don't know how to do this and I keep thinking of a thousand things I've done wrong. He was only 7. They don't know how or why and maybe I should have had an autopsy done??? I had just started to get my head around Bella being terminal, and now Chase is just gone.
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Nov 24, 2014 02:00
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Cats hide illnesses very well. Dont blame yourself. I mean, I know you will, and you're going to feel sad for a long time. You'll find yourself starting to feel better, then something like a noise, or putting your hand down expecting him to be there, and you'll feel sad not just for loosing him, but because for a moment, you forgot he was dead. And this is totally, completely normal. It is also extraordinarily painful. It is a black hole in your lungs, and a weight that feels impossible to shake. But do know that time heals this. This is not your fault. Paying more attention to Bella did not lead to Chase dying. Sometimes, animals just die. That's the horrible thing about owning pets. You will outlive nearly all of them. And that's one thing they don't prepare you for. Spend your time with Bella. Coddle her, love her, and harden your heart for when she's gone. And then, when you look at all these litterboxes and leftover food you have, go out and adopt another cat. They wont be the same, dont even try to find another Bella or Chase. Find someone that needs your help, and can help you.
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Nov 24, 2014 02:56
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| # ? May 14, 2024 14:42 |
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There are a few diseases that don't necessarily have clinical signs until it comes along and leads to their death - which in some cases can be very quick. Blood clots/other obstruction to the vessels of the lungs can be very fatal, very fast, and some of the causes aren't on the radar of most people because they are uncommon in some places.
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Nov 24, 2014 06:02
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