My so sweet baby, Gabby is in renal failure. The vet told us last month that she had less than 25 % kidney function left. We have been so upset. This cat means everything to us. So far though she is losing a lot of weight, she seems still happy. I have water bowls in the 3 rooms she usually stays in. She drinks so much water.
We started subcutaneous fluid injections yesterday. At first I was not going to do them when suggested last month. I hate to put her though any trauma but I am desperate now to keep her with me as I see the end approaching.
Has anyone done this treatment? Is it worth the trauma to her to do it? She hates it! But she did forgive me immediately after. I am hoping it will make her less thirsty, more comfortable.
So sorry. Can not help you on that but maybe can, on how to give shots. Does she have a treat she loves? If so give her the treat and gentle pinch the skin on her shoulders, if she excepts that then you might be able to give the shots with out any trouble. I had a cat that was diabetic, he actually loved shot time and he know that it was after he ate. And if he get extra food in the middle of the day he would bug me until I gave him a treat and pinched the skin on his back. He was never held during his shot time, he ate his treats and did not mind the shot at all.
Kell - I am so sorry about Gabby. Think about joining the Yahoo Feline CRF (chronic renal failure) Group. Here is the link http://pets.groups.yahoo.com/group/Feline-CRF-Support/. They have years of experience with cats in Gabby's situation and can give you support and help. I use one of the other groups for a different issue and they have been great and even my Vet asks me what "they" are saying as we decide on treatment. --Memory
Thanks so much for all your responses. I am surprised no one here has done this treatment. I thought it was quite common. We just gave her another 100 cc, can't say I see any difference in her behavior. Seems to be drinking the same amount of water as before.
Wren, it is not a shot per se, but an IV drip. It takes a few minutes to get it all in. And she struggles the whole time. You have to hold the needle (a painfully large bore needle) in the whole time. She is distracted until she gets stuck. LOL. She is so very smart. When she was new to us, I would put her outside every morning just before I left for work. She hated being outdoors. Within 2 weeks she had figured out what time I would reach for her to put her out and she would hide under my king size bed just as I went to find her. After about 3 days of trying to coax, then use a broom handle to force her out, I gave up and thought what is the harm in her staying inside? And I bought a litter box! I am expecting her to soon see us get ready and she will go into hiding.
Debbie, I am not sure how old she is. She found me when she was a mature cat. We have had her about 10 years. She has slept by my side every night since. Love at first sight. It went by way too fast. She does not look old though, she has never been sick though she was fat. She had a thing about food from the beginning and would eat as much as she could. Maybe because she lived on the streets for awhile on her own. Our other 3 cats were thin and I think it was because Gabby would eat their food. They hated her and would eat as fast as possible then go back outside to get away from her.
I have had many kitties over the years starting in grammar school but I have never had such a smart, loving cat as Gabby. She is truly 1 of a kind. She even follows me into the bathroom during the night and sits there until I am done then comes back to bed with me. She is with me constantly. Last week, I was deathly ill. I was in the hospital a couple of days. She waited by the front door my husband said. I usually fall asleep holding her 2 back paws. When I got home, I was too miserable. The sweet baby left her heating pad next to me, to move over to where my hand was and she held it between her 2 front paws.
Thanks AYankeeCat, I will definitely join this group.
I don't have cats, but both of my sisters in the last few years had cats with CRF and they both did the sub-q fluids. I don't know how much their cats enjoyed it, but I think they both had a couple more years of reasonably good quality of life because of the fluids so if I had a cat I would probably try it.
Has she been checked for diabetes? My last cat was a over weight eating machine, could not get weight off of him. Stole food-once that we know of he even stole the dog's food,ended up at the vet for that. But suddenly he started losing weight and peeing a lot. I know the signs of diabetes and took him in to the vet. Kidney failure is one side effect of diabetes.
I had a diabetic cat - also a stray, so I didn't know her age. I'd had her for about 5 years, when she was diagnosed, after her her water intake increased & her urine output increased & she started peeing outside of her box. She survived well with insulin for about 5 years. During the last months of her life, we gave her sub-q fluids, for a while. She hated it so much that I didn't do it for long - it was obvious she was nearing the end, & it became a quality of life issue.
I have another rescue now, who was diagnosed with CRF over a year ago. She's not more than 8-9 years old. She became extremely thin about a year ago & was drinking more water & peeing more, so we had testing done. Now, we're careful to leave her drinking water all over the place (filtered from the 'frig, because she seems to prefer that) & she's regained her weight & is stabilized.
As you already know, testing is key. Good Luck with your decisions. You need to do what works best for you & your kitty, and your needs & solutions may change as time goes on. My heart goes out to you at this difficult time.
Kell, I have done sub-q on animals, I am just not familiar with the renal failure.
She sounds like my Huck with her loving ways (and other cats being afraid of her).
As long as she doesn't seem to be in pain and suffering, is eating well and all that...then continue.
I am a big advocate in "let them die with their self respect" and if I can help them cross the Rainbow Bridge to minimize
their pain in any way, I will. I have had such a broken heart many times, and I do understand your position.
You really need more information on her condition and the guidance of someone who isn't out just for $$$ to
pad their pocket with raising your hope for a cure that won't happen.
Liz, I have to get Gabby eating more. She used to eat everything. Our other 3 cats died over the last year or so. All were old. The last 2 were brother and sister litter mates and were 19 and 20 when they died. After they went, Gabby suddenly only got fed twice a day and I stopped leaving dry food out that her sister Molly would eat 20 times a day. She would run in from outside and eat fast and run out again and repeat this all day long. Molly was a tiny cat so I wanted her to have constant access to food. Molly would not eat canned food. Gabby ate both. Once Molly was gone, Gabby started to lose weight. I thought it was from the lack of the dry food. I was happy, she was about 12 pounds and fat.
She now will only eat the Friskies canned food that has the gravy. She licks the gravy off and leaves the fake meat. I cook chicken breasts for her and she will eat that esp if I hand feed her. She also will eat anything from my plate. Last night she was eating pesto noodles. She will eat really weird things if on my plate. She goes nuts for it, like she is really starving. I have to stop her for she then vomits the inappropriate stuff up. I now usually have chicken or turkey unseasoned so I have something good to give her. She will only eat beef if I hand feed it to her from my plate. I want her to eat more beef for she is slightly anemic but she really does not like it. I know I spoil her. I have tried the low phosphorus food the vet sells but she refuses it. Tonight she has almost eaten half a chicken breast. But it has been over hours. I brought a bowl into my office and left it by where she is lying in the drawer on her heating pad between me and my keyboard. Every half hour or so she eats a few bites. If I leave it in the kitchen she will eat a few bites only and then not go back. The other day at the vet she was down to 7 pounds 2 ounces. She had lost 4 ounces in 4 weeks. I would give her back her dry food but the vet told me that was the worst thing for her kidneys. I meant to ask the vet if I should supplement Gabby's diet with taurine for I do not think she is eating enough canned cat food to get it. But I forgot.
Gabby is not diabetic. I have had her tested every year since I got her because she was fat. Her blood sugar has always been fine including last month. I also had her kidney function tested twice in the last 2 years when I noticed she was drinking more. The vet told me she was fine. We are now going to another vet.
Thanks Debbie. I am in dread!
Liz, I hope your kitty does well. Sounds like she is holding her own. She seems young to have kidney failure. What are you feeding her? I have water bowls all over too. But Gabby drives me nuts. She literally digs in the bowl and will tip them over then look all shocked when the water has gone all over the floor. I wonder what that digging is about. Maybe an instinct to dig for water overrides her usual smart brain. She also will dip her paw into the water as if she cannot see it. Though she can see. I watch her climb all over.
HI I am new here,just saw the thread title and was curious.
I had a cat go thru this.He was 16 and it just tore me up.Its the hardest thing to do.
My vet prolonged Bens life with a series of anti-biotics.
He lost weight and dug at his waterbowl as yours does. He was with me for 6 months after he was diagnosed.
My vet told me dry catfood wasnt as good for cats as people want to believe.Too many carbs.
I am sure his age was a factor also.
Alright, I am thinking here (before coffee, be patient) ...did she get her teeth checked? Could her mouth be sore and that why she isn't eating?
Our dear departed Harley Tucker would act starved, get to his food, take a bite or two...and just run away. He had something called stomatitus
at a very young age. BUT...tooth/mouth pain can detour them from eating big time.
Our Axl has crystals in his urine from the dry food...so yes, I think adding the taurine (talking to the vet at least) is a good idea.
Kell, please go out to the Yahoo Feline CRF group and at least read the posts of others if you don't want to post yourself. They have all been through CRF with their kitties and can help you find the kindest way to help Gabby.
Re: eating off your plate - IF she needs cat food just set a seperate plate for her at the table - she won't know that you didn't eat it yourself. LOL!
I can give you LOTS of information on managing CRF cats, including tips and tricks to make fluid admins MUCH easier on both of you. In fact, most cats learn very quickly that fluids make them feel loads better, and they become very compliant. One of my CRF cats would even come get me if I was late giving him fluids. You are correct that this is a very common procedure for CRF cats. Unfortunately, many vets don't teach their clients the tricks that make this an easy procedure.
I've got a busy morning here, but I'll post again later today and start your "tutorial". Don't despair. There is much you can do to help your girl feel better, including, hopefully, improving her appetite. In the meantime, please get copies of all of her lab work from your vet so that you can post them for me to take a look at. That'll give me a much better idea of her current condition and specific concerns.
I had a cat go through renal problems and she was on sub-Qs for roughly the last year of her life (~100cc per day). She was an absolute angel of a cat, though, and let me do whatever I wanted with her. She did seem to know that the fluids made her feel better.
One thing that helped me to learn to administer the IV was watching YouTube videos. There are lots of vets and owners out there who have taken the time to video themselves giving IV fluids to cats. This helped to take much of the fear and apprehension out of the process for me.
It's difficult to make specific recommendations without knowing exactly what you're doing for Gabby right now. Could you please post a complete list of any meds/supplements/treatments you're giving her now, and in what doses/frequency? Also, it would be very helpful if you could post her most recent lab results in their entirety (including all lab values and reference ranges). That would help me to offer relevant suggestions based on Gabby's current condition and treatment protocol.
SubQ fluids are the cornerstone of CRF management and can be truly lifesaving (or at least life-improving) for Gabby, because dehydration can make her extremely sick, weak, and inappetant. What brand and size needles are you using? What type of fluids are you using? Is anything being added to the fluids? Are you warming the fluids before administration? Are you restraining Gabby during fluid admins, and if so, how? There are a lot of tips and tricks to making fluid admins easier and even enjoyable for Gabby, and they center around the questions above.
Let me explain how I administer fluids and see if any of my strategies might work for you and Gabby. The most important element in keeping my cats compliant during fluid admins is properly warming the fluids. This is extremely important to the cat's comfort, because room temp fluids can seriously chill a cat. That’s why vets often use room temp fluid admins to reduce fevers. When I started giving fluids to my first CRF cat many years ago, the vet neglected to tell me about warming the fluids. As a result, my poor cat would struggle and tremble through the entire procedure. I called the vet clinic for advice, and one of the techs told me to warm the fluids. Problem solved! It was the difference between giving my cat a warm, soothing, internal shower, and holding her under an icy waterfall. She hated the icy waterfall. She appreciated the warm shower. If you've been using room temp fluids on Gabby she may continue to anticipate the chill of unwarmed fluids even after you start warming them for her. Just give her some time to trust that she'll be getting a warm internal shower instead of a cold one from now on.
You have to be very careful not to get the fluids too warm, however, and to err on the side of slightly too cool rather than any too warm. A little experimentation will help you find the fluid temp that makes Gabby most comfortable during admins. Here’s how I warm fluids for my cats (never use a microwave, as this can easily overheat and/or unevenly heat fluids). I place the fluid bag and most of the IV line in a sink of hot water, making sure to keep the connections of bag to line and line to needle dry and out of the water by anchoring part of the line on the vanity top with a lotion bottle. I leave the bag in the sink of hot water until the water cools enough so that I can dip and hold my wrist in it comfortably. When the sink water is comfortable on my wrist (like checking the temp of baby formula on your wrist), I know that the fluid in the bag is also a comfortable, warm temp. I remove the bag from the sink, gently rock it back and forth a few times to make sure that the fluid is a consistent temp, and proceed with the admin.
Below, you will see a photo of my fluid setup. I sit across the fronts of the chairs with my back facing the lefthand wall and legs stretched forward across both chairs toward the window. I place the cat between my legs and the chair backs. In that position, I can raise or lower my knees, if necessary, to help keep the cat from stepping or jumping over my legs. Between the chair backs, the walls, and my body, the only potential escape route for the cat is forward toward the window, and I can cup one of my hands gently around the cat's chest to prevent that escape. The cat can, however, move forward and back on the chairs between my legs and the chair backs. That freedom of movement diminishes the cat's inclination to fight restraint. I have found that the less restraint I use, the more cooperative my cats are during fluid admins.
If possible, do fluid admins alone. Again, most cats will be less stressed and more cooperative when handled in a relaxed manner and not feeling “ganged up on”. Your own mindset can have a tremendous influence on Gabby’s comfort level. If you are nonchalant and relaxed, she will be a lot more likely to respond in kind. If you are anxious and anticipating a struggle, well, that’s likely exactly what you’ll get. Before you start the admin, just sit there with Gabby for a moment. Close your eyes and imagine what a nice, warm shower feels like on your own skin. That’ll help put your head in the right place to provide a similar experience for Gabby.
It’s important to do everything you can to make this a relaxing procedure for another reason, as well. Anxious cats can tighten their skin so that it's as impermeable as steel, making it both extremely difficult and unnecessarily painful to insert a needle. The trick is to just sit there and stroke, rub, or scratch Gabby (particularly between the shoulder blades where you're going to insert the needle) until she relaxes and untightens her skin. Once you feel her relax, then quickly and smoothly insert the needle. If she refuses to relax no matter how long you stroke, rub, scratch her, then I recommend buying a portable IV stand so that you can take it wherever she is. Wait until she's napping soundly, then take the fluids and IV stand to her location, sit down next to her, and quickly and quietly slip in the needle while she's sleeping/drowsy.
Different cats have different preferences during the procedure. Some enjoy being stroked, scratched, or groomed during admins. Some like being fed. Some like listening to soft music. Some want to be left completely alone and have you sit there like a stone until the admin is finished. You’ll eventually discover the strategy that works best for Gabby.
I find it best to do fluid admins first thing in the morning. That way, the cat quickly learns that once the admin is finished, she is "safe" for the rest of the day and can relax without wondering if she's going to get stuck again.
Many cats start to get uncomfortable if more than 100 ml is injected into the same spot. The fluid pocket just gets too large. Avoid giving more than 100 ml in the same spot or during the same admin session. If you should ever have need to admin more than 100 ml/day (this is rarely necessary), split the total amount between a.m. and p.m. admins.
Now, about this large bore needle you’re using … vets often use larger gauge needles because it makes the procedure go more quickly so that they can move onto their next patient more quickly. Most cats, however, prefer a smaller needle. The needles that are popular with many CRF caretakers for at-home fluid admins are Terumo Ultra Thin Wall 20 ga. Terumo needles are considered by many (myself included) to be better manufactured and sharper than the Monoject needles that most vets use. The superior sharpness and smoothness of Terumo needles seems to be more comfortable for cats. The 20 ga. Ultra Thin Wall Terumos have a flow rate that is almost equivalent to the larger, more uncomfortable, 18 ga Monojects, as well. You can purchase Terumo needles without a prescription (from most states) from this site: http://www.thrivingpets.com/index.php/terumo-needles-box-of-100.html You can also purchase IV lines at the same site.
In case you're not aware, you can purchase Ringer's very inexpensively by the case if you call around and price shop at your local pharmacies. You probably won't find any pharmacies that keep it in stock, but they should all be able to order it for you overnight. You'll just need a prescription from your vet. I can purchase a case of 14, 1000ml bags of Ringers for $23/case from my local Target Pharmacy.
Hi Liz (ecrane3)! Sorry I earlier missed you last post. Long time no see!
Debbie, she does have teeth issues the vet said. But he said he would do nothing for them because of her kidneys. She does chew people chicken and turkey with no trouble.
Carla, sorry about your kitty! Great idea to watch YOU Tube videos on this.
ge1836, I do wonder what that water bowl digging is about. I do not remember Gabby doing this ever before. I wonder if your cat had a kidney infection that was causing her kidney failure which is why the antibiotics were given. Gabby had a urine culture which was negative. Though I do wonder where the blood is coming from in her U/A. I had not noticed that until I was just looking at her labs; the vet never mentioned it either. She did get a needle into her bladder for the urine specimen so I wonder if it came from that.
I was also giving her people tuna which she loves. Now I am wondering if it has too much phosphorus.
Thanks for all your help, Laurie. My husband came home early tonight to go to a Warriors game with my son so he quick did the deed and Gabby just lay there, no fight! She did immediately jump down after but is now back and giving me her belly for love. He stuck the needle in lower on her back and did not even hold it there. Maybe less painful location? We did skip yesterday because we all lacked the courage.
She is drinking as much if not more water. I was hoping she would be less thirsty.
If I find my camera I will take a photo of her labs. I think it may be in my car. They are all within normal range but
BUN 63 (14-36)
Creatinine 3.5 (0.6-2.4)
HGB 8.1 (9.3-15.9)
HCT 24 (29-48)
Specific Gravity 1.015 (1.015-1.080)
Occult Blood 2+ (negative)
She is on no meds. Nothing added. She is getting Lactated Ringers which is costing me $11 a bag and the needle is a Monojet 18 x 1A. I doubt I will be able to get an Rx for the IV fluid from the vet as he is making money (quite a mark up) on it. I do want to keep on good terms with him too. I will need him later on.
Kell - If your Vet is in California s/he is required by law to give you a Rx.
Senate Bill 175, approved by the Governor on 9/1/2003 and effective 1/1/2004, amends Section 4170 of the California Business and Professions Code to require vets to prescribe rather than dispense. The relevant sections are below:
4170. (a) No prescriber shall dispense drugs or dangerous devices to patients in his or her office or place of practice unless all of the following conditions are met:
(6) The prescriber, prior to dispensing, offers to give a written prescription to the patient that the patient may elect to have filled by the prescriber or by any pharmacy.
(7) The prescriber provides the patient with written disclosure that the patient has a choice between obtaining the prescription from the dispensing prescriber or obtaining the prescription at a pharmacy of the patient's choice.
(b) The Medical Board of California, the State Board of Optometry, the Dental Board of California, the Osteopathic Medical Board of California, the Board of Registered Nursing, the Veterinary Medical Board, and the Physician Assistant Committee shall have authority with the California State Board of Pharmacy to ensure compliance with this section, and those boards are specifically charged with the enforcement of this chapter with respect to their respective licensees.
(c) "Prescriber," as used in this section, means a person who holds a physician's and surgeon's certificate, a license to practice optometry, a license to practice dentistry, a license to practice veterinary medicine, or a certificate to practice podiatry, and who is duly registered by the Medical Board of California, the State Board of Optometry, the Dental Board of California, the Veterinary Medical Board, or the Board of Osteopathic Examiners of this state.
[quote="Kell"]she does have teeth issues the vet said. But he said he would do nothing for them because of her kidneys.[/quote]
CRF cats can (and often should) have dental issues addressed, but special precautions should be taken during any procedure involving anesthesia. If your vet is not comfortable with this and/or does not have the monitoring equipment necessary to keep Gabby safe under anesthesia, you should find a fully equipped surgical facility that does have the necessary equipment and experience to work safely on a CRF cat under anesthesia. This link will provide you with information about the precautions recommended: http://felinecrf.org/dental_problems.htm#dental_surgery
[quote]Gabby had a urine culture which was negative. Though I do wonder where the blood is coming from in her U/A. I had not noticed that until I was just looking at her labs; the vet never mentioned it either. She did get a needle into her bladder for the urine specimen so I wonder if it came from that.[/quote]
Blood can occasionally show up in a urine sample acquired through cystocentesis. It's also possible for blood to be present in urine as the result of inflammation in the absence of infection.
[quote]He stuck the needle in lower on her back and did not even hold it there. Maybe less painful location?[/quote]
Interesting. My cats are more sensitive if I stick them more than an inch behind the shoulder region.
[quote]We did skip yesterday because we all lacked the courage. ... She is drinking as much if not more water. I was hoping she would be less thirsty.[/quote]
Once you have her fully hydrated, she will likely drink a lot less. Skipping days isn't helping with her hydration, though.
[quote]If I find my camera I will take a photo of her labs. I think it may be in my car. They are all within normal range[/quote]
I'd like to see the rest of the lab results, esp. phosphorus, potassium, and total protein. It's important to note that "normal" ranges apply to healthy adult cats. They don't necessarily apply the same way to elderly, CRF cats. For instance, CRF cats should be managed so that potassium is in the upper half of its reference range, and phosphorus is in the lower half of its reference range. If potassium is below 4.0, you should ask your vet about supplementing potassium. If phosphorus is above 6.0, you should take measures to lower it (ideally below 4.0). You should read up on these on Tanya's site, as well.
[quote]She is on no meds. Nothing added.[/quote]
Not even a stomach acid reducer? Most CRF cats suffer from excess stomach acid, which can do a real number on their appetites. As a result, most CRF cats also take a daily stomach acid reducer like Pepcid AC or Zantac 75. I'm very surprised that your vet hasn't recommended this for Gabby. That's the second thing I'd recommend for her (the first being daily subQ fluids). This is something you should definitely discuss with your vet. You can read about stomach acid and its treatments on Tanya's site, as well. Also, if she's receiving daily fluids, it'd be a good idea to start supplementing her with B vits and potassium, both of which are excreted in urine. More things to discuss with your vet and research on Tanya's site. B vits may also help with Gabby's anemia.
There are also appetite stimulants that can be tried to help pique her appetite and stay her weight loss. Cyproheptadine is the med I have used for that purpose in my cats, though there are others.
[quote]She is getting Lactated Ringers which is costing me $11 a bag and the needle is a Monojet 18 x 1A. I doubt I will be able to get an Rx for the IV fluid from the vet as he is making money (quite a mark up) on it. I do want to keep on good terms with him too. I will need him later on.[/quote]
Your vet will be making plenty off you with a CRF cat. He shouldn't balk at providing you with any and all necessary scripts to help you reduce costs in managing Gabby's illness. And as AYC posted, your vet is legally obligated to write you scripts in CA, if you request them. If you believe that your vet will get angry if you request a script, then you might want to consider where his priorities lie in regards to Gabby's care. He may not be the vet that you and Gabby truly need. Just sayin'.
OK, now let's talk about Gabby's appetite and weight loss. As I already noted above, many CRF cats suffer with excess stomach acid that can make them feel chronically nauseous and inappetant. That's why most CRF cats routinely take an acid reducer. In Gabby's case, her dehydration and anemia are also likely to be playing parts in her lack of appetite. If her phosphorus is above 6.0, and/or her potassium is below 4.0, they could also be appetite issues. Dental problems can also put her off food. She's got a lot of potential strikes against her appetite, but all of them can and should be addressed. You should read up on all of these issues on Tanya's site for information and recommended treatments. Then you should have a long talk with your vet and insist on proactive treatments for her various concerns.
As far as food is concerned, the bottom line for ALL CRF cats is that THEY MUST EAT, regardless of the type of food (with the exception of anything toxic, like foods containing onions, garlic, chocolate, avocado, raisins/grapes, etc.). Low phos foods are advisable, but not if Gabby won't eat them. Canned foods are preferable, but not if Gabby won't eat them. If Gabby is only licking up a little canned food juice and is consistently losing weight, then you need to shift strategies and feed her whatever she wants to eat - even if it's high-phos and/or kibble. SHE MUST EAT! She will not survive long if she starves herself when offered more "appropriate" foods.
Since she likes canned food juice, try blending canned food in your kitchen blender with enough hot water to make it a warm gruel that she can lap up. She may prefer that consistency, and the added water will help her hydration. Also, offer small meals frequently. CRF cats will often reject large meals because of their diminished appetites. They'll be more receptive of a small meal offered every few hours. As I mentioned earlier, there are appetite stimulants that are commonly used in CRF cats. These should also be researched on Tanya's site and discussed with your vet.
The following links will provide you with more information on getting food into an inappetant CRF cat:
Thanks AYankeeCat for the info. I do not want to alienate this vet, at least yet. LOL. I have been thru quite a few around here having 4 cats for almost 20 years and also the cats before them. I have found most to have issues. So far this guy seems to be better than most. I guess I could start over again and start at the first ones I have been too and since avoided. There was one who wanted to know on his new patient sheet if I owned my house and how much was owed on it. When I balked at filling it out the receptionist said it was insurance if I could not pay his bills. I thought WOW this guy must be expensive. LOL. Another fixed my cat Molly who used to squat and pee wherever she was. So I had my husband at drop off for the surgery let the vet know and ask him if there was a physical reason for this. He charged us an extra $100 for looking at her kidneys during surgery. LOL. And then told my husband he needed to buy the food he sold in office.
K is 4.4
total protein 7.3
The vet did say he would add K to her fluid if it fell.
Those antacids, Pepcid AC or Zantac 75, are OTC. So if I know the right dosage for cats, I could just try them...
She will not eat raw anything. I have tried! I also tried thinning her cat food too with water and also low sodium chicken broth. She ate a little. She really likes that gravy in some of the Friskies canned food which I am sure is full of fake stuff to entice them. She didn't like the same looking stuff in the Fancy Feast brand. I will try heating her food up. She does like my hot dinner.
The good thing about Gabby's bod is that she has lots of loose fur due to her weight loss. So when we put in the 100cc we cannot even tell where it went. Even when I first got her, she had a huge belly and lots of loose fur. Her belly literally hung to the ground and it would sway back and forth as she walked. When she ran it was hysterical. I took her to the vet to check for feline leukemia and other illnesses before I would bring her home to my other cats. I also thought she was pregnant, she was so big. But the vet found her scar from being fixed. I wonder if she was pregnant when her previous family had her fixed.
After reading the info about excess stomach acid on Tanya's site I so called the vet. He is out today. I want to get Gabby on something immediately. She so has excess acid. Even down to her playing with her water. The worst is when she sits all night hunched over. Those are our bad nights. She does not want me to touch her but she looks so miserable. And that is a symptom listed. And she occasionally vomits white foam. So many more symptoms too. My poor baby.
[quote="Kell"]Thanks AYankeeCat for the info. I do not want to alienate this vet, at least yet. [/quote]
With the laws in CA, I doubt if requesting a prescription would bother your vet in the least. He probably gets asked for scripts all the time. In fact, if I read the statute correctly, your vet was legally obligated to offer you a prescription BEFORE he even sold you the Ringer's. I can understand your not wanting to alienate him, giving your experience with other vets. I've been through a boatload of questionable vets myself over the decades. But you don't deserve to be taken advantage of, either, esp. when there are laws in place to prevent that from happening in your state.
[quote]K is 4.4
total protein 7.3
The vet did say he would add K to her fluid if it fell. [/quote]
Those values look good. So good, in fact, that you might want to consider Calcitriol for Gabby. You can read about it here:
[quote]She will not eat raw anything. I have tried! [/quote]
Then feed a small (nickle-sized or smaller) piece of cooked liver daily, instead. But try warming a little piece in a baggie placed in hot water for a minute first. You might be surprised at her response to REALLY SMELLY, warm, raw liver.
[quote]She really likes that gravy in some of the Friskies canned food which I am sure is full of fake stuff to entice them. [/quote]
Try putting the entire can of Friskies in your blender with a little hot water and puree it. The flavorizers in the gravy will distribute through the puree, and the whole thing will puree to a uniform "thick gravy" consistency so that there won't be any meaty pieces for her to lick around.
[quote]The good thing about Gabby's bod is that she has lots of loose fur due to her weight loss. So when we put in the 100cc we cannot even tell where it went. [/quote]
I know exactly what you're talking about. My previously obese cats are very easy to give fluids to, because the fluid has so much extra "space" to distribute into.
Thanks for all the reading material. What little I read on Calcitriol was a bit overwhelming with all the office visits we would need to make. Gabby gets hysterical in the car. I make my husband take off work so I can baby her when we go but she still gets so upset which cannot be good for her. I will read more about it later. It is our nap time. LOL. Well Gabby has already started to nap in her drawer here but we will go to bed. I am still not over being so sick.
I will try the liver warmed. I wish we had a place to get organic liver near here. I should eat it too, I am very anemic. Is chicken liver good too for iron? Probably not. I do think there is organic chicken liver available at Safeway.
I found on Tanya's site this symptom for excess acid, "Licking Gravy Only The cat may lick the gravy only and leave any solid food behind. However, this may not indicate excess stomach acid in all cats, only if it is a new behavior..."
And it is a new behavior! Gabby used to eat everything and anything.
What I most excited about is if I can end with the antacids the times she sits all hunched up. That is when I wonder if I should end her misery.
The vet is calling tomorrow so I will ask about the vitamin Bs. IV form? I am trying to remember if there is iron IV. Of course this is not IV really so some meds can cause tissue damage.
B vits can be injected into the injection port on the IV line during subQ fluid admins. Do NOT, however, mix B vits into the fluid bag itself, because B vits deteriorate quickly when exposed to light. If using injectible B vits, you'll only need to add them once every week or two.
Iron is given orally with food. Be forewarned, however, that iron is constipating, and constipation is a common and often VERY painful condition in cats. It can also completely destroy appetite. Now that I mention it, what does Gabby's stool look like (color, texture, size, shape)? If she's producing small, hard balls that may look more like clay than stool, she's likely constipated, and that could explain both the inappetance and the hunching. Her stools should look like tootsie rolls (elongated and brown) and be squishable. If she's constipated, there are OTC remedies for that, as well.
Slippery Elm Bark can be very soothing in the GI tract. It can help with everything from excess acid to constipation to diarrhea to mouth ulcers to stomach ulcers to ... Heck, SEB can help from mouth to other end. It can be purchased from health food stores and administered according to recommendations on Tanya's site. It can also be used in conjunction with traditional acid reducers like Pepcid AC or Zantac 75 (with several hours between them).
OK, I just did some liver research. Turns out, chicken liver is substantially HIGHER in iron than beef liver. And cooking makes it even higher per weight in iron content. Unfortunately, cooking also increases the amount of vit A in liver, and vit A is toxic in excess. So, if you're going to cook liver for Gabby, make sure to only give her a very small piece daily (dime size or less) to avoid vit A toxicity.
The following link allows you to look up nutrient values in just about any type of food:
Baby Gabby just got her first dose of Pepcid AC, 2.5mg. I have such high hopes this will make her feel better. Already I think I can see a change with the SQ fluids. She now is so good, she just sits there. She does jump down right after but comes right back. She is purring more. Oddly her litter box is not saturated with pee though. I am not sure if I should be happy or worried. It seems to me she is drinking as much water but maybe not. The litter box would be so wet so fast. My husband tells me it is relatively dry now. So I worry her kidneys are shutting down but she does not seem edematous. Her poo is bit loose though.
I am now thinking I may bring her to a specialist. I was not impressed with the vet today. He did tell me to give her 5mg of the Pepcid AC after I asked but from Tanya's site she clearly thinks you should start at 2.5mg QOD. I have only been to the emergency and specialty vets a few times over the years. They charge so much. It is like $300 to just get in the door and of course they order every test known to man. I do not mind paying but I do not like being taken advantage of either. I guess I am paying for their knowledge more than their actual actions. I just do not want to be too intrusive and make her life all about treatments and going to the doctors. It is so hard to know what is right. I wish she could talk to me.
Oh BTW, I have been sticking her IV bag and tubing inside a tight plastic bag and then wrapping it all up in my heating pad at about 150 degrees for 20 minutes before we infuse it. It takes the chill off yet it stays dry and is not messy.
I'm so glad to hear that Gabby is doing better with the subQ's, I would caution you, though, to be VERY CAREFUL using a heating pad to warm the fluids. You don't want the fluids getting any warmer than about 101-102 degrees, or you could burn her. It's safer to warm the bag in hot water that you allow to cool to wrist-warm. Regardless of how you warm the bag, make sure you test the fluid on your wrist before administering it to Gabby. Also, rock the bag back and forth several times to distribute the fluid so that it is a even temperature.
With all of the extra fluid in her system, it wouldn't be at all uncommon for her to be urinating outside of the litterbox somewhere you haven't discovered yet. That may explain the lack of increased wetness in her litterbox.
Soft stool is definitely preferable to constipation, and it's most likely resulting from her increased hydration.
Vets tend to dose according to guidelines published in Plumb's Veterinary Drug Handbook. What some vets seem to overlook, however, is the potentially stressful effect that many drugs can have on the kidneys, and the importance of minimizing that effect by utilizing low doses whenever possible. Depending on the drug, it's often more prudent to start with a low dose and increase only if necessary within the recommended dosing guidelines.
Unfortunately, CRF can affect lots of body systems. Things can change very quickly and require adjustments in management protocol to keep the cat as healthy as possible. Regular blood monitoring is necessary to identify if and when electrolyte imbalances need to be corrected, if infections arise, when anemia requires aggressive treatment, etc.. But since Gabby is already slightly anemic, blood draws must be kept to a necessary minimum. One thing that you should have done, if your vet hasn't already done it or doesn't have the necessary equipment to do it, is to have her blood pressure checked. This is important, since hypertension is not an uncommon condition in CRF cats, and it should definitely be medically managed if present.
Geez, LOL, we had quite a night after Gabby got her Pepcid AC. She was racing around my bedroom at 100 miles an hour. At first I thought she was just feeling so much better but then as the night progressed and I was trying to sleep she decidedly did not want to. She would repeatedly put her paw on my face and flex her claws so I would wake up but not get scratched. Then she would talk to me. LOL. She would climb all over me and push her head into mine. She was a riot. Then she slept to noon.
I am going to bring her to a specialized vet. I have my choice between a vet with Clinical Interests: trauma cases, feline urinary diseases, internal medicine but specializing in : Emergency/Critical Care and one that is a highly trained internist who has Clinical Interests: urinary and gastrointestinal diseases but not in just cats. This place charges $1000 to start per night. So lets hope she does not need that. LOL
Right now she is sleeping in front of me while I maul her. How she can sleep with me all over her little body, I will never get but she loves it. I always have 1 hand on her. LOL She has a thick undercoat that is so nice to touch.
Here she is on her heating pad in the drawer of my desk. If I am at my desk so is she! I have to lean over her to type. Gabby is a Traditional Siamese, an Applehead. She is really a love bunny.
I think Gabby's belly was feeling so much better with the Pepcid AC that she spent all night trying to convince you to get up and FEED HER!!! LOL! I can just imagine how happy that bothersome girl made you with her shenanigans last night.
I think if I were you, I'd see if you could talk to both internists on the phone and see what they have to say about Gabby. That'd give you a good idea of which one you feels would be the better veterinary match for her and you. You want a vet who will listen closely and partner with you, not dictate to you. You need a vet who you're not scared of offending and not reluctant to talk to and question. And, of course, you need a vet well-versed in current management strategies for feline CRF.
Gabby is a VERY interesting girl! Is it just the lighting, or is she a tortie point? I didn't know that Siamese could be tortoiseshell color until I just Googled it.
Thanks AYankeeCat. I have never liked the Siamese look before Gabby but now I find her beautiful. LOL. Though I still do not find the Modern Siamese attractive at all.
Hi Laurie! I should not have exclaimed that the Gab is an Applehead because in truth I have no idea since she was a stray. I didn't even know there was such a breed known as an Applehead Siamese. Then a friend from DG posted a pic of her kitty on Facebook and she looked just like my Gabby. In talking to her she told me her cat was an Applehead. I looked them up and Gabby sure has the look, face and body, and the personality; extremely bright, very bonded to her human, and people often feel they are just like a dog. So I decided Gabby was one. She is a torti for sure.
We just got home from dinner and she greeted us with such exuberance. She is feeling better for sure. At dinner I told my husband that I was bringing her to the emergency vet clinic to see a specialist. We have brought several cats there in the past in an emergency after hours like when 1 was shot, and our bills have been astronomical. He was so cute. He said definitely go and do whatever there for Gabby. He said for sure it will be less than cloning. I have seriously been talking about cloning her all month much to my husband's chagrin.
I just got a response from Meow Mix about their phosphorous levels in their food. WOW, everything you could possibly want to know and more. At first I was thrilled, it looked like the phosphorous levels were so very low (.18 to .22%). But then I saw Meow Mix posts all their nutrient levels "As Fed" which are show low low phosphorus numbers and also as "Dry Matter" which are consistently over 1% which is too high. I am thinking on Tanya's list, she must post the levels of "dry matter." I so need to find food that is available to me that is in gravy. Gabby will only eat those but maybe that will change as the Pepcid AC works.
Laurie, the heating pad really works well. Even when I forgot it and left it wrapped for 1 hour, the water was not too hot. The fluid in the tubing gets too hot but I just flush the tubing. It is just so convenient to do it that way. I imagine as the water level decreases in the bag, it will get warmer faster. So I will be careful.
Does Gabby have blue eyes? Don't all Siamese have blue eyes?
When you take Gabby to another vet, make sure you have copies of all of her previous vet records and labs with you so that tests don't have to be repeated. Also, resist having any blood tests that aren't absolutely essential run on her. Every drop of blood she gives from now on is likely to make her anemia worse, and that's NOT something you want to happen. She will, of course, need to have her blood monitored with this disease, but those tests should be performed as infrequently as possible in an anemic cat to preserve her blood volume.
Is there a university vet school anywhere within reasonable driving distance of you? If so, you may be able to find a renal specialist there who might be your best bet with Gabby.
I've mentioned both of these before, but they bear repeating: 1) Your primary feeding consideration should be finding foods that Gabby will eat. If those foods turn out to be low-phos, great. If not, still great if she'll eat them. With CRF cats, eating is top priority. WHAT they're eating is second priority. 2) Try pate-style foods pureed in a kitchen blender with a little hot water. If she likes gravy, she may like a pate puree that she can lap up.
Yes, Tanya's food lists are "dry matter" basis.
Yes, fluid bags heat up more quickly when they have less fluid in them.
Thanks for asking AYankeeCat! It is amazing how much you can love these little bundles of fur. I have had so many cats in my life and always thought I loved them but I did not or at least not deeply. Well there was one about 25 years ago that had our hearts but we had a child then so that love reigned supreme. I just adore this cat, maybe because she adores me! Right now she is sitting up in the drawer looking at me wondering if it is dinner time yet. The Pepcid Ac pills really seem to be making a difference. Though she hates me giving it to her. I find I must just set my teeth and just do it fast.
I am such a wuss.
I also did the lactated ringers treatment yesterday instead of my husband. I was traumatized. I really was and she knew it and fought me hard. The funny thing was I was an IV therapist for a few years, years ago. It was one of my most favorite jobs and I was excellent at it. LOL Gabby is now wise and 1 look at the bag or at Tom coming into the office and she tries to run into the bedroom. So we must shut the door immediately when Tom walks into the office.
Hi Laurie. There is a vet school but it is too far for Gabby to go. She cries the whole way in the car and gets into a tizz. I make my husband come on outings to drive so I can hold her. He is not happy! LOL. I rather make it easier on her and take her local. The older I get the less money I spend on me so ...
She does have blue eyes; beautiful blue eyes. I had read a long while ago that cats will never look you in the eye. I do not know if that is true but Gabby is forever looking me right in the eye.
Thanks for all your help Laurie and everyone else!!!
Poor Kell. Go back and reread my post of Jan. 23 regarding my fluid admin procedure. You obviously don't lack the skill to do this. You're just psyching yourself out because of your relationship with Gabby. You need to turn that around and use it to your advantage by convincing yourself that fluid admins are soothing and lifesaving gifts for Gabby ... which is exactly what they are. It's all a mind game.
Where the Pepcid is concerned, have you tried Pill Pockets? They come in several flavors. My cats ADORE the duck flavored ones. If you can't find the "allergy formula" duck flavored ones locally, you can order them online. The trick is to cut the PP in half so that it's small enough for the cat to swallow whole without chewing. Even if Gabby won't eat the PP willingly with the Pepcid inside, I have found it MUCH easier to admin a pill inside a PP even if I have to stuff it down the cat's throat. They're a lot less likely to try to spit it back out if it's in a PP.
All of my cats look me in the eye, but the only one who regularly gazes so deeply and for such extended periods of time that he seems to be reading my soul is Bobble. It's unnerving at times. I've never known a cat to spend so much time "reading me" in that manner. Or maybe he's trying to meld our souls together.
I discovered Flaver Doh to wrap around pills instead of pill pockets. We tried the fish flavor and "someone" got in the cupboard and ate half the tub of Flaver Doh all by himself. Sometimes I give everyone a dab of Flaver Doh as a treat to get them used to the idea without pills.
LOL wren107 and Laurie! So much for my Gabby looking lovingly into my eyes, defying her feline nature because we are soul sisters. LOL.
Reminds me when I would wake up in the night and she would be asleep on my chest She was too heavy but I thought "Ah, she loves me!" so I would let her stay there. When back awake, I turn my heating pads back on (they stay on 2 hours only.) 1 night upon awakening with her heavy on my chest, I turned Gabby's heating pad back on also. As soon as it heated up she moved off me to her pad. I repeated this the next 2 nights and each time she moved off me to her hot heating pad as soon as it warmed up. I then realized she was only on me for the warmth, no love involved. LOL
Yes Laurie, I am a big wuss. I hate hurting the baby girl. And in doing so, I make the experience even worse for her and for me. I am going to try again tonight with firm resolve. Last night she was so still for Tom, he does not even have to hold her down.
I have never even heard of pill pockets or Flaver Doh. I will have to look for them on Amazon. I got a Rx too for Lactated ringers so I need to call around for a good price. Thank you both for your suggestions!
[quote="Kell"]LOL wren107 and Laurie! So much for my Gabby looking lovingly into my eyes, defying her feline nature because we are soul sisters. LOL.[/quote]
Don't discount the importance of those long, loving glances. They may not be defying her feline nature, but they certainly express great emotion.
[quote]Reminds me when I would wake up in the night and she would be asleep on my chest She was too heavy[/quote]
Years ago, my 26.45 lb Noddy (RIP) would lie on me and knead my chest with his VERY polydactyl, baseball glove-shaped paws. I often considered renting him out as a defibrilllator!
[quote] I then realized she was only on me for the warmth, no love involved. LOL [/quote]
These little monsters sure can make us feel used. Phantom used to lick my hand and then rub his face on it. I didn't have to worry about looking like an old dish rag. Phantom had already turned me into a face towel!
[quote]Yes Laurie, I am a big wuss. I hate hurting the baby girl.[/quote]
That's EXACTLY the point I've been trying to make. Stop thinking about it as a hurtful procedure. You're not hurting Gabby. You're helping her! Your husband approaches it that way, and Gabby accepts it that way.
[quote]I have never even heard of pill pockets or Flaver Doh.[/quote]
I keep both on hand in my personal "pet pharmacy", though I've only tried the beef flavored Flavor Doh (marketed for dogs, but I figured it'd have equal appeal for cats - I was right about that ... the dogs and cats both hate it equally). I'll stick with Pill Pockets for the cats and raw hamburger for the dogs.
If you get to the point, as many of us CRF caretakers do as the disease progresses, where you're giving multiple meds and supplements to Gabby, another helpful trick is to buy #3 or #4 empty gelcaps from a pharmacy. You can often fit several meds into a single gelcap for ease of administration, and the gelcap itself masks the taste and odor of the meds (even moreso if you then put the gelcap in a Pill Pocket).
Other pilling tricks:
1) Give the cat a cc or two of food gruel or water by syringe immediately before and immediately after pilling. This wets the throat to make swallowing easier before pilling, and forces swallowing after pilling.
2) Coat the pill or gelcap with butter to make it more palatable and to help it slide down the throat easier.
3) Use a piller. I prefer the Bullseye Pillgun because pills don't get stuck in it the way they sometimes do with other pillers.
I find that tuna water makes a great chaser after a pill at my house.
I give the food bowl, let them have a bite or two and then wham! in goes the pill or a treat ball (hiding pill) is offered and then they are back to greedily eating before they know what happened. I think attitude counts as much as anything in adminstering meds - the person's attitude more than the pet's.
Kell if she winks at you with both eyes that is a love wink, mine liked me to wink back
Back when I had my 3 they would all sleep on or touching me. Ming would have her head tucked under my chin(all most all of her 17 years she sleep that way,thought at first all of her fit under there), Missy would be either on my back/hip/butt and big boy Impy would be between my legs. At night I was not allowed to more!!!!