I have been wondering about you and your kitty, and how he has been doing.

I mentioned it before, but want to reiterate that I've had great luck with slippery elm bark and tummy upset/appetite stimulation. I swear by the stuff and it is extremely safe. Any health food store should have it. I give my girl a whole capsule rather than stir it up in water- I think it works better that way.

I'm sure you will hear a lot that cats hide their distress very well, which is true, but you know your guy best and if he's still interactive and seems comfortable to you that's a good sign.

Have you tried to get him to eat baby food? My cats will turn themselves inside out for turkey or chicken baby food.

Good luck and continued prayers.

Thanks, quasifish. I'm going to try both of those things. How long does it usually take the slippery elm to take effect? Also, do you think I should stop the cipro (since it doesn't seem to be helping anyway)? I'd like to keep the number of things I'm shoving into his mouth to a minimum so he doesn't hate me too much. :)

Make sure you read up on slippery elm on Tanya's site before giving it to your boy. You need to make sure you are administering it at the right time relative to both the time you feed him and the time you give him his other meds and supplements. Timing is all important when juggling food, meds, and supplements to make sure everything is and isn't interacting the way it should.

I used slippery elm and Zantac 75 with Bitsy, and I don't think either one helped him much, but I wouldn't hesitate to try either or both again with another CRF cat. You just never know what'll help any particular cat. I'd sure try slippery elm and/or Pepcid AC OR Zantac 75 with your guy since you haven't mentioned trying any of the stomach acid reducers yet. He may be walking away from his food so quickly because the excess stomach acid makes him too nauseous to eat. You really don't have anything to lose in trying to control his stomach acid and see if that'll help restore his appetite.

I'm concerned that he hasn't had a bowel movement in two weeks, esp in light of the fact that he ate a can and a half of food after those Valium treatments. Constipation is a common side effect in CRF cats, and it is extremely painful. It will also DEFINITELY cause a cat to become completely inappetant. There is nothing you can give him at home to clear his bowels if he's impacted. The vet will need to take care of that. BUT, there are things you can do to avoid constipation recurring. Ask your vet about lactulose and read up on it on Tanya's site. It was a lifesaver for Bitsy when he was on phosphorous binders which can be very constipating.

I'd recommend taking him back to a vet to have him checked for constipation and bowel impaction. There's nothing you'll be able to do to convince him to eat if he's impacted until the impaction is cleared.

I'm glad he's still hanging in there and is not hiding all the time.

Laurie

I'm taking kitty to the vet this afternoon. I'm so afraid he's going to tell me this is it. I don't want to keep torturing the poor thing, if that's what I'm doing, but it just doesn't seem like he's that ill. I don't THINK I'm in denial.

I have always understood that vets generally know more about specific illnesses than I do (although that hasn't always proven to be the case), but I have also always known beyond any shadow of a doubt that no vet ever has or ever will know any of my animals as well as I do. I have learned to trust my own instincts when it comes to the general state of being of my animals. I've had vets who have never even laid eyes on one of my animals recommend euthanasia based solely on test results, when in reality, the animal was simply not yet ready to go.

Trust yourself. No one knows your boy as well as you do. If he seems reasonably happy, interactive, and comfortable most of the time, then don't let a vet convince you otherwise. Vets know mechanics. You know the heart and soul of your boy. Listen to the vet's information and recommendations, then listen to your gut. Then go home, sit in a quiet room with your boy, and listen to him. Only then should you make any decisions.

Laurie

My knowledge is limited, so like Laurie said, read up on Slippery Elm at Tanya's site. My kitty is only on thyroid meds at the moment, so I don't have to worry a whole lot about interactions. My vet told me to try Tagament (generic version) as an acid reducer 1/4 tab 1-2x per day. I don't know if that's the same as one of the other brands, but it didn't help my poor kitty at all. With the slippery elm, it's usually less than an hour and she's ready to eat something. It's worth a try at the very least- it doesn't cost much at all.

I'd also be worried about bowel impaction and hope you get some good news from the vet regarding that.

(((HUGS)))

Laurie, thanks for the thoughts. What have you done when a vet hasn't wanted to treat an animal and you thought further treatment was warranted?

quasifish, we were typing at the same time. Thanks.

BTW, DH noted that when he came with me last week that the vet directed most of his conversation to him rather than to me. We have noticed this with every male doctor we have encountered (when dealing with my mother during her illness, for example). Ugh.

I've been in that position before, and I've found another vet who was willing to work with me. I live in a very rural area where the veterinary pickin's have been slim at times, so it hasn't always been easy to find a vet who would respect my treatment decisions and work with me as a partner in my animals' care. My primary vet now realizes that I'm not going to give up on any of my animals until I am convinced it's time, so he doesn't even bother to try to talk me out of further treatment or into euthanasia. However, he also doesn't necessarily offer me all treatment options (esp. if he thinks it's time to stop treatment), so I usually do my own research and then discuss options I've found with him. As much as I like my primary vet, if I think he's off-base with the treatment of a particular animal, I won't hesitate to go to another vet for a second opinion.

I can tell you from my own experience that vets generally treat me with more credibility if I walk into the office as well informed as possible. When dealing with something like CRF, for example, you're likely to get a more helpful response from a vet if you walk in with a good working knowledge of the more common meds and supplements used to manage the various symptoms and issues that can arise with that disease. For instance, instead of saying, "My cat won't eat", and waiting for the vet to offer suggestions, you might get more helpful recommendations if you say, "My cat has been trying to eat but starts crying after the first bite and then goes and hides. Could he have mouth sores or be very nauseous, and if so, can you check for sores, and may I try Pepcid AC or Zantac 75 for the nausea?" In my experience, vets tend to offer more information to clients who are already well informed, perhaps because they realize you have an interest in learning about the disease and its treatments.

If you do decide to seek out another vet, you might also consider speaking with the new vet on the phone before making the appointment. Explain your situation and ask the vet to be very frank about their treatment philosophies regarding terminally ill animals. Explain that a previous vet has recommended euthanasia, but that you don't feel your cat is at that point yet and that you want to pursue reasonable management of the disease for as long as humanely possible. Explain that you are looking for a vet who will assist you in the management of your cat's CRF until YOU decide it's time to let him go.

I must admit that I've never made such a pre-appointment call to a vet myself. I sure could have saved myself some time, money, and aggravation along the way if I had, though.

Bottom line - Don't waste your time trying to argue with an uncooperative vet. Find one who will work with you to help your boy for as long as you feel it is the right thing to do.

Oh, if you do find a different vet, make sure you get copies of all of your boy's vet records and test results from the other vets he's seen since his initial CRF diagnosis. It's very important that a new vet have those things to review.

Laurie

The vet was very nice yesterday. He agreed with us that whatever is wrong with kitty is not apparent from clinical exam. He took blood, took an X-ray, and recommended an ultrasound to see if we can find out exactly what the problem is. He gave him another Valium treatment (Laurie, don't yell at me! it's only .01 ml), and kitty inhaled another half can of food without showing any distress during or after (no sign of pain, no indigestion, no vomiting). The vet checked his mouth and didn't see any signs of ulcers or sores. There is no jaundice either. When we brought him home, he drank a good amount of water, went to one of his comfy spots, and slept for a few hours. I really think he's feeling better. BTW, he hasn't lost any weight since the August exam.

In the vet's opinion, kitty is not in any pain and doesn't seem to be distressed by what we're doing, so we might as well proceed and try to find out what's wrong. (As long as we don't mind paying for it!!)

So kitty is back at the vet's awaiting his ultrasound today. I'm really curious about the results of the blood test.

I'm very glad that the vet is willing to work with you to make a diagnosis and treat your boy. Did he find anything in the x-ray? Make sure you get a copy of his blood test results so that you can monitor and track all of his blood values, not just the liver and kidney values.

When does he have his ultrasound? I've discussed ultrasounds with several vets, and they all emphasize how important it is to have ultrasound performed and interpreted by a vet who is very experienced in ultrasound technology and diagnostics. If I were to have an ultrasound performed on one of my animals, I'd have to travel 100 miles to the nearest city to find a specialist who could properly perform it.

As far as the Valium treatment is concerned, I understand why you keep allowing it, but it's extremely risky without a blood test BEFORE administering the Valium to make sure your cat's liver is healthy. The amount of the dose isn't the issue. The health of your cat's liver is. Each time he receives Valium, it's like playing Russian Roulette with his liver. If you give him one dose too many, and he goes into liver failure, he's done.

Be sure to post any info you get from your vet about the x-rays, blood test, and ultrasound!

Laurie

Kitty had his ultrasound yesterday, and it's bad news: he has a large mass, probably a cancerous tumor, in his small intestine. One kidney is not functioning, the other one is functioning partially. His BUN was up to 131, creatinine to 8.5. His liver is okay, I believe. The ultrasound guy apparently thought we could do more testing to find out exactly what the mass is, but the vet advised against it, because it would be invasive and the result would be the same. He recommended euthanasia, but thought it was fine to take kitty home and pamper him, no needles or meds, for a few days or even a week. He thought it would be clear when it is time.

Kitty appeared to be having trouble breathing last night, but it must have been some aftereffect of the ultrasound, because this morning he seemed comfortable and happy. He drank some water, used the litter box, and had settled in one of his favorite spots in the living room when I left for work.

So it seems that what has been making him feel sick has been the tumor. The kidney problems probably would have become apparent soon but were sort of a red herring. This is probably why he didn't respond to the treatment.

We're very sad, but I do feel better knowing what is really wrong and that there is nothing else we could have done.

I am so extremely sorry for the diagnosis. I am glad, though, that you had the additional testing done.

I do have a question that may seem odd. I'm still wondering where the heck the two cans of food he has eaten have gone if he really hasn't had a bowel movement since before his first Valium treatment. Is there any possibility that the mass isn't a tumor at all but is a major impaction of all that food, instead? I know it sounds like I'm grasping at straws, but that food waste had to go somewhere. If it hasn't come out, it's still got to be in his digestive tract somewhere, doesn't it? And if it's all impacted there in his small intestine, might it not also be toxifying his kidneys?

Perhaps he does have a much smaller tumor in there that prevented the digesta from moving past it, causing an impaction behind the tumor?

This is just how my brain works. Always asking questions until things hopefully, ultimately make sense.

I hope you will reconsider stopping the subQ fluid treatments. Dehydration will make him feel very ill and miserable within a couple of days. That's not the way you want him to leave this world. Go ahead and stop the other pills and meds if you feel it's time to let him go, but please keep giving him fluids until you're ready to euthanize. They will help keep him as comfortable as possible for as long as possible.

Such difficult decisions, I know. I also know that you will do what you believe in your heart to be best for your boy.

Take care,

Laurie

Laurie, thanks for the thoughts. My DH did ask the vet the same question you had about where the food went, and he said that wasn't the problem.

If you think about a can of cat food without the water, there's not much substance to it. Particularly when eaten over the course of 5 or 6 days, even two full cans would not amount to much of a mass. Kitty was already so dehydrated that any liquid probably got absorbed immediately.

He has been drinking a good amount of water on his own the past couple of days. If I notice he seems to be uncomfortable, I will consider giving him fluids again.

Harriet, Laurie is so right about suggesting that you continue with the sub-qs. If a cat is drinking a lot, it means that he is in an advanced state of dehydration...as you noted, cats get their fluid from the food they eat, and he is not eating much. Unless the fluid administration is very traumatizing to your guy, it will make him much more comfortable for how ever much time he has left.

Incidentally...I had Max put down not because of kidney failure, but because of his badly impacted bowels...He was regurgitating what he was being force fed and I didn't want to put the poor fellow through another enema. But until the very end he actually looked forward to his twice a day fluids...when he heard me preparing the bag he would hop up on the sofa where I hung the bag.

Best Wishes

lisa

I'm so sorry you've gotten terrible news. My thoughts and prayers are with you.

As the others have said, use the sub-q's since you have them. It will make him feel more comfortable.

(((HUGS)))

Kitty still seems to be comfortable and content, though withdrawn in comparison with his healthy behavior. I am so torn about whether to give him anything. He's drinking what looks to be a normal amount of water a few times per day, and he doesn't seem to be in pain. He's using his litter box to urinate (a couple of times a day, normal amount) and is able to get up and down the stairs to the basement. I was wondering if I should give him the liquid vitamins, at least. OTOH, the vet said not to bother -- just let him do what he wants. The vet said the ultrasound gives 99.9% certainty that kitty has a malignant tumor, so there's probably not much that can be done. We feel that when an animal so strongly rejects food that it's cruel to force him to eat.

He's never been a super-cuddly cat, but he has always made it known when he wants a lap. He purred and acted happy when I picked him up and cuddled him yesterday and then held him in my lap.

Harriet,

With kitty's high BUN and creatinine numbers, he is becoming toxic and needs subQ fluids to flush as much of the toxins out of his system as possible. He is physically incapable at this point of drinking enough water to do the job himself. Let there be absolutely no doubt about that. He IS becoming dehydrated, and he IS becoming overloaded with toxins. If you are going to do anything for him, give him fluids.

Laurie

We gave kitty 100 ml of fluids about 5 hours ago. I can't tell if it made him feel better or not, but it didn't seem to hurt him. He has mostly been sleeping in a little basket he staked out many months ago as his special spot, but I just picked him up and put him in my lap, and he started purring immediately. He seems to be somewhat uncomfortable but not in pain -- he doesn't cry when I pick him up or shy away from being touched. He's been going downstairs every day and using the litter box.

He surprised DH last night by eating ONE piece of dry food. But AFAIK that's all he's eaten since Tuesday.

I hope we're doing the best by him. He does seem relatively content and is relaxed.

Hi I have a 16 yr old cat, and she has not eaten in 7 days and has not had a bowel movement either, she is drinking and using the litter box. she does not seem to be in pain and cuddles as always. When I called the vet they said to bring her in. we are on a fixed income, I asked if I could make payments they said No,so i called every vet in the county and they all said the same thing NO! we have no savings and no credit cards. what do people in our situation do? no family or friends either. we are leaving it in Gods hands and making her as comfortable as posible.all we are asking for are your prayers to. Thank you, Bianca

Try calling around to cat rescue groups, or the humane society/shelters in your area -- they may have some suggestions.

There is a place online that puts out the call to help animals in need when their owners can't afford it. I wish I could remember what it was called. I'll check around and see what I can find.

My heart goes out to those of you with sick, elderly animals. I've had many cats in my life, and I've had to go through that sort of thing more than once.

Thank you, I did call the humane society and they said they had no funds to help, I'm not very good with the computer, what do I do to look up rescue groups? Thank you so much for your help, I just hope pooh can hang in there. Bianca

Bianca--if you look up petfinder.com, and do a search for cats/kittens in your zip code, it will give a listing of cats/kittens for adoption in your area. Usually it will list organizations from closest to furthest, and you can use their contact info to contact them. same with local animal shelters. They might be able to point you in the direction of low cost vet services. Good luck.