Been over 24 hours and gabapenten isn’t wearing off

[epona]

I was thinking on my drive to work. I'd like your opinions please. I'm also going to discuss this with the vet tomorrow, and I have a feeling she'd agree with me because she kept telling me "got to think about the quality of his life". But I want to hear more.

He has an appt on Saturday. He gets stressed out at the vet to the point where I have to sedate him with Gabapentin for the vet to even remotely check him over. Given how poor his kidneys are now and how long it took for him to get out of it (3-4 days) and the fact he isn't eating, I am really hesitant to even give him a small dose for the vet. I am also hesitant on bringing him in without gabapentin where he'd get too stressed out. I am not sure if he's too weak to not even fight the vet without the sedation, I don't want to risk him going into feral mode and the vet can't do anything and make things worse.

Then I started thinking..

What if the numbers got worse? Then what? There's nothing more to try, right? No other treatments aside from a transplant and that isn't going to happen. I am doing what I can now with the fluids and trying to get him to eat. If I am paying $400 just for the vet to tell me it got worse, it would break me knowing there's nothing more I can do. I don't think knowing the numbers would offer a peace of mind.

But what if the numbers get better? Then I can continue to do what I am doing and keep hoping. Nothing will change treatment wise.

Essentially, there would be nothing different or new to try, right? I'd just be stressing him out by taking him in just for numbers with nothing more to do. I can at least see for myself if he gets better (or worse), I really don't need numbers to tell me that. The only reason why I'd take him other than bloodwork is for blood pressure, but seeing how he's acting now with zero improvement in nearly a week, I'm not sure if it matters anymore.

I am heavily debating on cancelling the appointment and continue to do what I am doing and take care of him, knowing the vet is only a phone call away if I need her.

What would you guys do in my situation?

I actually discussed this with my vet, and we're in agreement (and this was proposed by the vet) that as Jakey is now in stage 4 CKD there's absolutely no point in doing full blood tests any more to look at his kidney numbers - there is no way on this earth that they are going to get any better, and he's either going to die of or with kidney failure, probably sooner rather than later.

Everything we do from this point on is purely about maintaining a decent quality of life for him, and the subQ fluids are to help him not feel unwell and "hangover" type feeling every day, not to save his life or anything.

Checking those kidney numbers again is just throwing money down the drain, because we know they're bad and they'll stay bad.

What he did say was that there is a simpler blood test that just checks for blood count which can be valuable if anaemia is suspected, as cats with advanced CKD on certain medications can become anaemic and that can be treated to improve their quality of life.

 

[Draco]

epona that’s exactly what I was thinking. Those bloodwork is not cheap, though it isn’t about the money. It’s about my boy’s comfort. Whatever the numbers say isn’t going to change what’s happening or the treatments.

you and I are basically in the same boat, I feel you and Jakey. If you ever need to chat feel free to reach out to me. Lots of loves and hugs for sweet Jakey

 

[Draco]

Just spoke to the vet and she agreed with me about not taking Monet in. Just keep him comfortable and continue fluids. She gave me a phone number for home end care if I need it too.

 

[iPappy]

Just spoke to the vet and she agreed with me about not taking Monet in. Just keep him comfortable and continue fluids. She gave me a phone number for home end care if I need it too.

It sounds like the vet has Monet's best interest, as well as comfort in mind.

 

[epona]

Just spoke to the vet and she agreed with me about not taking Monet in. Just keep him comfortable and continue fluids. She gave me a phone number for home end care if I need it too.

Well hopefully for both you and I we'll have a bit longer with our boys yet, I know some cats do keep going and stay happy for a long time with end stage CKD on fluids at home, so it's not all doom and gloom.
But yeah if taking him to the vet will stress him and is unlikely to provide any new information or treatments, then it's important to consider the potential benefit vs. the stress to the cat.

Jakey is actually alright with vet visits, I'm currently taking him once a month for a Solensia injection which helps with his arthritis, and I take him in if there's something else going on like a UTI that needs treatment, but I don't think at this point I'd take him in just to have more blood tests about his kidneys - no new information can be learned from doing that, we know they're broken.

 

[Draco]

He hasn't eaten at all today.

I took him outside on the porch and he seemed to enjoy it. Explored and sniff things for about 10 mins before he decided to go back inside to lay down. I know he isn't feeling well when he wasn't trying to eat the plants that he always tries to attack. Weather permitting I'm going to take him outside often as he wants, give him something to look at and smell other than a wall. Fresh air too. I tried bringing food outside to see if he'd eat it there. Nope.

How long can a senior cat with stage 4 CKD go without food before they start to seriously crash? Just so I can prepare myself more.

 

[FeebysOwner]

I am so sorry about Monet not eating today. Maybe it is just one of those days, and he will do better tomorrow. CKD cats can go through relapses and rebounds - Feeby did.

There is no way to put a time limit on this - not really. All you can do is what you've been doing, continue to try to get him to eat, and do things, as you are doing, to give him some joy.

It really sucks, I know.

 

[rubysmama]

I'm also sorry to read Monet didn't eat anything yesterday. With Ruby, she was eating some every day. In fact her last day she ate a lot, so much that I thought she was rallying, however, then she vomited up most of it. I don't know how long a senior cat with stage 4 CKD can go without eating, but in Ruby's case I think dehydration is what caused her to crash, which if you continue giving Monet the Sub Q's will be different than it was for Ruby.

About not eating, though, of course there's the worry of fatty liver.
Why Has My Cat Stopped Eating And Is It Dangerous? | TheCatSite

I know there's lots of threads on the topic here at TCS, but if you want to read more, there's a Renal Cats Reddit that is quite active.
https://www.reddit.com/r/RenalCats/new/

Sending hugs to you and Monet.

 

[Draco]

Monet, 15, had been diagnosed with stage 4 kidney disease. The creatine number was 9.5.

For a week he hasn't been eating very well. A bite here, a bite there. But the past 2 or 3 days, nothing at all. He refused his food, he'd look away. I've been giving him anti-nausea meds as well as appetite stimulant on his ears daily. Nothing. not even a spark of interest in food.
For 5 days so far I've been giving him subQ fluids, there has not been a change.
He's been laying in a corner on my treadmill, only moving for his water or his litter box. He's been in loafed position.

Like any cat, it's hard to tell if he's in pain, but clearly he's not himself.

Today is Saturday. Vet's closed tomorrow and Monday (Veterans Day). I work all week and don't have any more time off for him. I could take him to the ER vet, but I'd rather him go to the vet I know and trust. Plus, costs too.

I've been battling all day yesterday and this morning. Should I take him in today before he gets worse? Should I do the kind thing and let him go now while he isn't suffering too much? Should I do the kind thing to myself and not watch him be this way? If he hasn't eaten much at all or nothing in a week, I don't think he's going to turn around at this point, especially when the fluids aren't perking him up.

I think I know my decision. I called the vet and waiting for her call back to discuss before I take him in today. But, I want to hear your thoughts and experiences.

 

[Kris107]

No one here can make this decision for you. Many of us have been in similar spots though. I find this decision so hard, but as you said, you think you've made the decision. Try to come to peace with it as the decision often haunts us later. The more resolve you feel knowing you did the right thing at the right time, the better. You know your cat the best. Try to remember this is ultimately an act of love. It is not easy and I feel for you.

 

[FeebysOwner]

I can't say any more than what was said above. Talking to the vet is a good idea. If it makes you feel any better, ask them what they would do if it were their cat. In the end, as said above, as lonely as it feels, the decision has to come from you and you alone. That won't stop how badly you feel if you move forward now, but your resolve is what can help to soften the blow.

 

[Draco]

I spoke to the vet and we agreed it’s time. He has a 12:40 appt. My mom came out to be with me.

thank you all for your kind words.

 

[rubysmama]

I was typing something else when you posted your update, so deleted it. One thing I was going to say though, was that I hoped you had someone to support you, so glad your Mom is coming with you. I'll be thinking of you.

 

[FeebysOwner]

There are no words... Having just gone through my cat's death, the sorrys are appreciated, but they feel woefully inadequate.
Bless Monet and you.

 

[epona]

Much love to Draco and Monet

 

[catsknowme]

We are with you in thought and spirit as you courageously give your precious treasure that one final gift. I am sure that rescuers everywhere are blessing you. Sometimes True Love is letting go, knowing that ending our beloved's misery means the beginning of ours. In ancient Egypt, the whole society would respect your period of bereavement. I pray that you get a sign of celestial encouragement - a rainbow, a sunset, a shooting star or ....... many ehugs

 

[epona]

I'm so sorry, please know that you did all you could, including this final part.

 

[Draco]

He and I spent an hour outside enjoying the fresh air and sun while the gabapentin worked into his system. By the time I got to the vet, he was so calm and quiet (when he'd usually get extremely upset). He was ready, he knew. The vet was so kind and gentle, it was peaceful.

I chose a private cremation and his ashes.

I made my peace knowing I did the right thing for him. I didn't want to see him deteriorate any further, I didn't want him to suffer and be in pain anymore. I said my goodbyes, and I know he'll be waiting for me at the other end of the bridge. Now I need to heal and continue my life, he would want that. I have Cassie by my side.

If the mods would like to close this thread or move it to the crossing the bridge forums, please do.

 

[epona]

He and I spent an hour outside enjoying the fresh air and sun while the gabapentin worked into his system. By the time I got to the vet, he was so calm and quiet (when he'd usually get extremely upset). He was ready, he knew. The vet was so kind and gentle, it was peaceful.

I chose a private cremation and his ashes.

I made my peace knowing I did the right thing for him. I didn't want to see him deteriorate any further, I didn't want him to suffer and be in pain anymore. I said my goodbyes, and I know he'll be waiting for me at the other end of the bridge. Now I need to heal and continue my life, he would want that. I have Cassie by my side.

If the mods would like to close this thread or move it to the crossing the bridge forums, please do.

I'm so sorry for your loss. You did the absolute best you could, and Monet would have known that - it sounds like he was ready to go and you let him do so in a dignified way.
I'm so very upset for you though, I know what it's like to say goodbye.
You did the right thing.

 

[FeebysOwner]

I am glad the two of you got to spend an hour in the air and sunshine together. I am also glad that you feel he was ready, and that you are peace with it. Since there always has to be an end, there is no better one than that - for the both of you. RIP little Monet.