Am I overreacting?

FeebysOwner

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It probably has already been suggested (and I forgot) but maybe adding some water to her dry food (in a separate dish, of course as a trial) to see if she would like it that way which would give her extra moisture. That might also help with the stool volume.

As far as Cerenia, you could test giving it every other day and see what happens. Any change at all, and then back to every day. Or is there a way to reduce the amount every other day (one day full dose, the next day half dose, repeat, repeat, repeat). You could also wait and see what the vet says since you have an appt. coming up.
 
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Twylasmom

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Of course today she is not eating as well, but she did have a nice poop. The Fortiflora may be helping a bit there. I have enough Cerenia to give everyday until her appointment on Friday so I’m just going to do that and then discuss options with the vet. I’m hoping that her weight has at least stabilized and there is improvement on her bloodwork.
 
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Twyla’s vet visit was today and most of it was positive. She has gained weight (almost a half a pound!) since her visit three weeks ago, Her heart rate was also better today.

Her T4 went down from 5.6 to .8 (low normal). As expected this caused her kidney values to worsen: BUN went from 42 to 56 and her Creatinine went up from 2.2 to 2.7 And her SDMA went from 26 to 40. In order to find a better balance we are reducing her methimazole dose from 2.5 mg twice a day to 1.25 mg in the morning and maintaining 2.5 mg in the evening. Even with those kidney values her phosphorus numbers improved, going from 6.1 to 4.4 and her potassium was also in normal range. So the kidney diet is definitely helping her phosphorus levels. She did get subqs today for the first time and a B12 shot.

My vet suggested starting her on subq fluids once or twice a week. I want to do this but confess that I have a terrible needle phobia and am also concerned that I would be able to do this on my own. With my last CKD cat I actually took her to the vet twice a week for her subqs, but I live farther away now so that isn’t practical. I am wondering if I might be able to find a pet sitter who is experienced in giving subqs that would be able to do it for me and might even work with me to get comfortable doing it on my own. I’m just scared I would do something wrong.
 

FeebysOwner

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I hope they want you to have her T-4 tested again in another 3-4 weeks, just to see if they lowered the dose enough. Going from 5.6 to 0.8 is drastic and I am surprised she hasn't shown signs of an issues with too much of the meds. Although, some of the weight gain might be a result of that.

Are you testing her for dehydration - the 'scruff' test? Gently pull up on the skin at the base of her neck and then let go. If the skin goes back quickly, odds are she isn't dehydrated. If it tents or goes back into place slowly, that is a sign of dehydration. A creatinine level of 2.7 doesn't necessarily warrant sub-Q fluids, especially if she is eating/drinking well and in light of her weight gain.

But that is a call to be made between you and your vet. You could try checking for cat owners in your neighborhood (Next Door Neighbor web site) to see if any of them have experience with sub-Q fluids or know of someone who does. They too might be able to help you get more comfortable so you could do it on your own.
 
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I hope they want you to have her T-4 tested again in another 3-4 weeks, just to see if they lowered the dose enough. Going from 5.6 to 0.8 is drastic and I am surprised she hasn't shown signs of an issues with too much of the meds. Although, some of the weight gain might be a result of that.

Are you testing her for dehydration - the 'scruff' test? Gently pull up on the skin at the base of her neck and then let go. If the skin goes back quickly, odds are she isn't dehydrated. If it tents or goes back into place slowly, that is a sign of dehydration. A creatinine level of 2.7 doesn't necessarily warrant sub-Q fluids, especially if she is eating/drinking well and in light of her weight gain.

But that is a call to be made between you and your vet. You could try checking for cat owners in your neighborhood (Next Door Neighbor web site) to see if any of them have experience with sub-Q fluids or know of someone who does. They too might be able to help you get more comfortable so you could do it on your own.
Yes, she is going back in five weeks for a recheck. I was shocked her T4 was so low and am fully on board with reducing the dosage.I do give her the scruff test most days and the majority of the time it snaps back quickly, once or twice it went back more slowly. We have an awesome community Facebook group here that is devoted solely to cat owners so plan to reach out there to pet sitters who are used to administering sub-Q fluids. I am also trying to reintroduce more wet food in her diet. Prior to starting her on the prescription dry food her diet was 75% wet food with water added and now it is maybe 25% wet food. So even though she drinks well her water intake has decreased. I may see how everything goes and wait until her next visit to make the decision on fluids.
 

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Any day that her skin snaps back quickly is a day she likely does not need sub-Q fluids.

Some of the prescription foods also come in canned versions, so you could check those out, in addition to the non-prescription low phosphorus foods on Tanya's web site. You could also test adding some water to the dry food to see if she would eat it that way, as that would also add more moisture to her diet.
 
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Twylasmom

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Any day that her skin snaps back quickly is a day she likely does not need sub-Q fluids.

Some of the prescription foods also come in canned versions, so you could check those out, in addition to the non-prescription low phosphorus foods on Tanya's web site. You could also test adding some water to the dry food to see if she would eat it that way, as that would also add more moisture to her diet.
Over the past four months I have tried over a dozen different foods from the list on Tanya’s site without much success. Twyla liked the FF Salmon Primavera for awhile, but it didn’t last. Anything by Weruva or it’s related brands has been a no go, as has been anything that comes in a pouch. I am going to retry a couple of the wet prescription foods now that she is eating better. She went through a spell where she was turning up her nose at any wet food, but the past few days she has shown interest in Sheba pates again. So I may try those with a fraction of a dose of phos binder, or her fave FF pates. Even if it’s half a three oz can it would help with hydration, as I do add water to it. She is loving the chicken baby food as a treat but don’t want to overdo that since it isn’t nutritionally complete for cats.
 
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Twylasmom

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After reading over the Sub-Q fluids information on Tanya’s site it seems to me that I should wait before starting fluid therapy. Twyla’s creatinine level doesn’t seem to warrant it, she’s not vomiting or apparently nauseous, and her appetite is good. I will continue to check for dehydration and if it becomes an issue I will reconsider. From what I read, starting earlier isn’t necessarily beneficial and once you start you are committed to continue. Her next appointment is in five weeks and I will reevaluate at that time. Thoughts?
 

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I'm with you, I think, on the fluids, from what I've read (although I didn't recall that once you start you're committed but that's probably just that I missed it since Poppycat is not requiring this yet), but in any case I believe you're right to shelve it for the moment.
 
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Fingers crossed that Twyla may have found a new wet food she likes! I drove 40 miles round trip this morning to pick up a few test cans of Royal Canin 12+ Loaf in Sauce, since the closer stores were all out. I just gave her 1/4 of a can with a tablespoon of water mixed in and a couple of Temptations crushed on top. She ate almost all of it in one go! Hopefully this will continue.

This is a food that isn’t listed on Tanya’s site. It’s a pate style and has phosphorus at .56% on a dry matter basis. If she will eat it consistently I can increase her wet food intake and decrease her dry, which should help somewhat with her hydration issues. I want to try it out for a few days before ordering a case but also wanted to mention it as a potential option for those with pate only eaters.

(In other news I just finished watering my outdoor plants about twenty minutes ago and we are now having a torrential downpour) :lol:
 

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I drove 40 miles round trip this morning to pick up a few test cans of Royal Canin 12+ Loaf in Sauce,
Thank you for this - I am on the hunt for foods that I can use in Poppycat's current situation and after doing a little research today this one appears to fit the bill :heartshape:
 
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Thank you for this - I am on the hunt for foods that I can use in Poppycat's current situation and after doing a little research today this one appears to fit the bill :heartshape:
I hope Poppycat likes it! Twyla is having a picky day today and hasn’t been as enthusiastic about the RC or the Sheba or even baby food. Frustrating because she has been eating really well lately. I keep telling myself not to get anxious about how much she eats on one day and to look at it over several days. I gave her Cerenia this morning and am seeing how she does with getting it every 2 or 3 days.

I am still kind of waffling about starting subqs especially if they might help with her appetite. I am working on desensitizing myself by watching videos of the procedure though I still think I will need a helper when I do start doing it. I have noticed over the past week or two that her urine output is less than before we started methimazole, though still more than my younger cat and what I would consider normal or slightly more than normal. I’m assuming that is likely because of the large drop in her thyroid levels? She drinks water regularly but I wish that she would eat more wet food.

I’m also a little unsure about the phosphorus binder. I discontinued it when she really wasn’t eating well but if she will only eat higher phophorus wet food I may need to reintroduce it. Is it too much to use the phosphorus binder in the wet food if the majority of her diet is dry, low phosphorus kidney diet?
 
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If the majority of her diet is low phosphorus food, I don't think you should be giving her any phosphorus binder.
Thanks for your input! Twyla has had a good morning, ate some dry food, took her morning meds and ate almost a full portion of Sheba. And I discovered last night’s capsule of meds spit out on the floor - the first time she has tricked me! I’ve been using size 3 capsules, which are a little big but all the vet had. My size 4s should arrive today which should be better. If it’s just one pill I don’t bother but if she needs to get two or three the capsules are so much easier and hide the taste.
 
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I really hope things are going to continue like they have the past several days. Twyla is eating great and does not have to be coaxed into eating! Still not a huge fan of the kidney wet foods or the low phosphorus Royal Canin loaf (last night I gave her a 50/50 mix with FF pate, she nibbled at it and then went over and polished off the pure FF on Hooper’s plate!) but I keep trying. But she does like the primavera again, which is the best FF option anyway. Her weight has stayed steady at just over 11 pounds since her vet visit and her poop looks great. I think the mini-dose of Fortiflora that I marinate her dry food in helps with that. Absolutely zero vomiting. She just seems to act like she is feeling better overall. So hopefully her current methimazole dose is the right dose. Cerenia every other day seems to work best for her.

One weird thing - she has always gone crazy for her catnip banana but now she doesn’t seem to respond to it. I wonder if there is something about her medications that dulls the response. She is playful in other ways. Has anyone ever noticed anything like that?
 

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Hi maybe the toy just went "flat" and has lost its zing and attraction? That's what happens here.
I've read that if a toy like this is dampened, that can help "refresh" it. I also keep Poppycat's extra toys in a zippy bag that I've poured loose dried catnip into.
 
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