Elderly CKD Cat Jakey Has Progressed to Needing Fluids (IV outpatient followed by regular SubQ at home)

[epona]

Got to see a vet today and have a box of extra strong antibiotics for Jakey - fingers crossed this sorts it out (he's had e.coli bladder infections before since his kidneys got really bad, so that's our first port of call).

 

[fionasmom]

Around here, most vets have gone with a very large corporation and are now resorting to similar practices which heavily rely on online communication. I just spent a few minutes online trying to get an answer as to why they can still ask me to book vaccines for a dog who passed in 2022 but can't give me yesterday's invoice.

ETA: I hope that gives Jakey some help!

 

[epona]

He seems to be a lot more relaxed and comfortable tonight, I've not seen him wee in the last couple of hours, but I think that means the antibiotics are starting to do their thing, he's eaten a reasonable amount of his dinner and is in a nice relaxed sleeping position on my lap, and no agitation or back and forth to the tray/weeing all over the place.

Fingers crossed that he's on the mend. I know this is likely to happen again given the stage of CKD he's in, but getting treatment quickly is key in keeping him comfortable and happy.

 

[epona]

Does anyone have a link for any info about urinary incontinence (physical weakness and/or behavioural) in elderly cats with CKD and repeated UTIs?

Jakey has had a few painful bacterial UTIs (common in CKD cats) in the last year and part of what is going on with him is behavioural - since he started getting UTI issues earlier this year, he won't actually willingly pee unless someone is with him. So if I am at home I will stand by the litter tray and he will come over and pee either in the tray or on the inco pads around it (which is also fine) - I praise him when he goes either in the tray or in the pads and don't comment and just quietly clean up when he misses or goes somewhere else.

If no-one is in the room with him when he wants to go, he'll just go wherever he can get to, but he will also try to hold it in until someone is with him - and a lot of the time there is someone with him, but having stage 4 CKD he drinks a lot, has SubQ fluids, and wees A LOT so he is often caught short. Holding it in isn't good for him and we do take him to the litter tray and stay with him as often as we can.

He also pees in his sleep, which is involuntary.

We've got some awesome washable pee mats which are comfy and warm and wick fluids away from him, he always sleeps in the same spot these days so we just put a pee mat there and he curls up on it.

I was considering getting some Vetfleece to go on top of the pee mat for extra comfort, as urine will just go straight through that into the pee mat underneath.

Anyone with any experience or tips? (Not going to be putting him in a nappy/diaper btw!)

 

[Meowmee]

Does anyone have a link for any info about urinary incontinence (physical weakness and/or behavioural) in elderly cats with CKD and repeated UTIs?

Jakey has had a few painful bacterial UTIs (common in CKD cats) in the last year and part of what is going on with him is behavioural - since he started getting UTI issues earlier this year, he won't actually willingly pee unless someone is with him. So if I am at home I will stand by the litter tray and he will come over and pee either in the tray or on the inco pads around it (which is also fine) - I praise him when he goes either in the tray or in the pads and don't comment and just quietly clean up when he misses or goes somewhere else.

If no-one is in the room with him when he wants to go, he'll just go wherever he can get to, but he will also try to hold it in until someone is with him - and a lot of the time there is someone with him, but having stage 4 CKD he drinks a lot, has SubQ fluids, and wees A LOT so he is often caught short. Holding it in isn't good for him and we do take him to the litter tray and stay with him as often as we can.

He also pees in his sleep, which is involuntary.

We've got some awesome washable pee mats which are comfy and warm and wick fluids away from him, he always sleeps in the same spot these days so we just put a pee mat there and he curls up on it.

I was considering getting some Vetfleece to go on top of the pee mat for extra comfort, as urine will just go straight through that into the pee mat underneath.

Anyone with any experience or tips? (Not going to be putting him in a nappy/diaper btw!)

I would ask your DVM about it. I found these links. I don’t think my cats that had chronic kidney disease had incontinence, at least I don’t remember. I remember Giorgio, one of my outdoor cats I took in and tried to save, had that at the end of his life, but I don’t know what was causing it because they never figured out what was wrong with him.

It could be that the kidney disease, etc. is affecting his sphincter muscles on the urethra and there are drugs for that, but I don’t know if it would be OK for him.

Urinary Incontinence in Cats

Dr. Erica Thacker explains urinary incontinence in cats, including symptoms, causes, diagnosis, and treatment options.

www.petmd.com

https://hospital.vetmed.wsu.edu/2021/11/10/chronic-kidney-disease-and-failure/#:~:text=What%20are%20the%20symptoms%20of,weakness%20from%20low%20blood%20potassium

 

[Draco]

A lot of great info on this thread. Im going through the same thing and learning as well.

Epona I do hope your baby is on the mend. You're doing a wonderful job taking care of your baby!

 

[fionasmom]

Three steps to feline urinary incontinence management: Diagnosis, diagnosis, diagnosis
I don't know if this is even vaguely helpful, but there can be a lot of subtle causes to urinary incontinence. Some causes don't even have to be in the urinary tract.

I wonder if he associates pain with urination and thinks that if someone is there it might not happen or he might be able to get some help.

 

[epona]

Three steps to feline urinary incontinence management: Diagnosis, diagnosis, diagnosis
I don't know if this is even vaguely helpful, but there can be a lot of subtle causes to urinary incontinence. Some causes don't even have to be in the urinary tract.

I wonder if he associates pain with urination and thinks that if someone is there it might not happen or he might be able to get some help.

He is very very people-oriented - he goes to humans for comfort.
When he got his first UTI a few months back, he was having painful urination and unlike some cats who might go and hide, he would come to me and ask me to go to the litter tray with him, or if he couldn't make it that far he would get on my lap and pee on me because I am his safe space and his main comforter.

So I think a lot of it is behavioural, he spent 3 days at the vet clinic on IV fluids last month and the vet nurse said day 1 he held his pee in all day until she picked him up to put him in the carrier to go home then he peed on her. Day 2 she checked to see if his bladder was full, and as soon as she touched him he peed - he is just afraid to pee if he's by himself because he wants comfort of having a person there in case it hurts, he remembers pain from his UTIs.

This most recent UTI he would come to me to pee on me or on the floor or sofa right by me.

What I have tried to do is lead him over to the litter tray several times a day to have a pee, which works to an extent - but due to the CKD, he drinks a lot, gets subQ fluids and therefore urinates a lot and often gets caught short, and he pees himself in his sleep too.

 

[epona]

I took a photo of him on one of his washable pee mats - they're quite good - robustly made, large, warm fleecy type top, tough chew and claw proof non slip rubber backing, and locks fluids away quite well. They are comfy for him to sleep on and if he has an accident it doesn't go through to the sofa or leave him in a puddle. It helps that he only has 1 spot he sleeps in.

Anyway, I thought you might enjoy a photo of the wee fella

 

[Draco]

he is beautiful! I wanna hug him.
Where did you get the pad from? I want to save it in case I need something like that

 

[silent meowlook]

He is so I handsome!!!

 

[fionasmom]

He is such a sweetheart and it is so touching that his faith in humans makes him feel better if they are around. I have used lots of washable pee pads and they can be a real lifesaver for everyone involved.

 

[epona]

he is beautiful! I wanna hug him.
Where did you get the pad from? I want to save it in case I need something like that

Thank you! He loves being hugged, and would probably appreciate it - I sometimes call him my teddy bear cat

I don't think my info is going to be much use to you, as I got my washable puppy pads from a very small UK company called Pet Impact, I don't know whether they ship internationally, and if they did it would probably be costly - you're likely to be able to find a company/supplier your side of the pond if you google for Washable Puppy Pads it will suggest suppliers closer to home.

You could also look at washable incontinence bed pads intended for human use which may well be cheaper, but you'd need to check that they can withstand chewing and/or cat claws, it needs to be a thick backing and a top layer that won't shred or catch claws in it, human ones may not take this into account in their design.

Washable Puppy Pads - Pet Impact

 

[epona]

The poor wee love continues to decline gradually.

A couple of weeks ago he was getting dehydrated and weak again so on veterinary instruction we increased his fluids to 50 to 60ml daily (from 50ml every other day).

That helped perk him up a bit, but now he is bleeding from his backside, it's fresh bright red blood around his stools and leaking after he's done a bowel movement, I think it's probably to do with his constipation.

So we have another vet visit in the morning. I'm exhausted at this point but would do anything for my little love - I'm going to see what the vet says, but Jakey is still interested in us, cuddles, affection, food, and his surroundings, so it will be difficult if he's still mentally with it but his physical state has declined such that he's going to start to suffer.

I worry that I am going to have to have him euthanised due to some stupid physical complication while he is mentally alert and expecting to come home from the vet to have his dinner and cuddles.

It's been easier with previous cats, like with Sonic there was a day when he mentally checked out so to speak (declined to sit on my lap as usual and refused food, had lost interest in everything) and we knew that was it, Jakey hasn't done that but is getting physically weaker and more frail and more things gradually going wrong, while his will to live seems strong but his body may not be up to it

 

[silent meowlook]

I am so sorry. I know this is so gut wrenching difficult.

 

[epona]

Took him to the vet this morning, she felt a mass in his abdomen.
Obviously with his advanced age and being in end stage CKD already there's no point in investigating or treating it, other than pain relief.

We've got an appointment on Monday to have him put to sleep.

 

[AbbysMom]

I'm so, so sorry. I hope you have lots of quality time with your boy this weekend.

 

[iPappy]

I am so sorry to hear this bad news about Jakey. It's absolutely gut wrenching. I just lost a cat to CKD who was still mentally alert. It made it agonizing to make that decision, but her physical body was failing fast and the only thing I could do was spare her what could possibly be a very slow, painful passing.
I will keep you both in my thoughts and prayers. Hugs to you both.

 

[DeesCats]

I'm so sorry to hear this news about Jakey. I'll keep both of you in my thoughts.

 

[silent meowlook]

I am so sorry.