High Sodium in blood... hospital stay opinions?

[Ocean Planet]

Hi all,

My 17 year boy was diagnosed early this summer with kidney disease. (It's sad because he doesn't need that on top of his IBD). He stopped eating Thursday so I took him to the vet Friday and they gave him some meds and fluids to pep him back up.

They called me today to say the bloodwork they took shows he has a very high sodium level due the way his body is processing things as well as the kidney disease. He has all the signs of this condition...weakness, low appetite, drinking a lot... etc. Note, he has been on 100ML of fluids per week for the past 2 months.

Long story short, the doctor recommended a 2 day hospital stay to get IV fluids to bring this level down. They said it requires a hospital stay because they need to do the process slowly. If sodium drops too fast it can cause brain damage.

I'm torn because I'm afraid of what 2 days in a hospital will do to his stress levels at 17 years old vs. letting him live out his days as comfortable as I can make it at home. Taking him to the vet once a week for fluids has started to get stressful. When I put him in the carrier, he sprayed me the last 2 times to show his annoyance with the situation! I am dedicated to making him as comfortable as possible, but 2 days sounds like a lot. As I type this, I wonder if I could try one day....

As you read this, what does your gut tell you if that was your kitty? Don't be afraid to say either way, I won't take anyones answer as the end all, be all solution. Appreciate anyone who shares a thought!

Edit - I know every vet his different, but if anyone has any inside information on what it's like for them to stay overnight might be helpful too. I've never had animal be kept overnight before..

 

[ColoradoCat]

I think an important thing to think about is any other health issues he has and how severe they are. If he could live another year or more after the hospital stay, it might be worth it. If he has other health issues that could prove to be a problem in the not-too-distant future, it might be best to do palliative care. I'd also take into account how the stress levels could effect any health issues he may have.

I myself had to go through this sort of decision with my own 17-year-old boy earlier this year. In his case, I decided the treatment he would've needed for cancer not only may not have done much, but it might have exacerbated the heart and kidney disease he was already dealing with.

I'm sure that whatever you choose, it will be the right decision for your little guy. Just remember that 17 years is a long life for a cat, and I'm sure his has been wonderful.

 

[fionasmom]

I am sorry that you are in this position with your older boy. What your vet is telling you is completely true. The sodium level can be a danger to your cat and you are seeing some of the symptoms. Unfortunately, the administration of the fluids does have to be controlled by the vet.

Your cat has never stayed overnight at the vet's? How is he at the vet's in general. You said he sprayed you in the car, but does he calm down at the hospital? What is the overall prognosis for your cat? If he gets through this could he live on for a while?

If you think that the stress will put him over the edge, be up front with the vet and see if he has any other information which might help you make a decision. If you absolutely do not want to leave him, ask if there is some middle ground of something that you can do to help him at home....which I am not suggesting that there is. Also ask about immediate and long term consequences of not doing this.

If you decide not to do this, can you do palliative care at home to keep him comfortable?

 

[Ocean Planet]

Thank you both for answering! Fortunately, I've never had any of my cats stay overnight before so this is new to all of us. When he is at the vet they say he does pretty well. I think he is just getting tired of going is why he sprayed me, I'm guessing.

I just spoke to the doctor again and they said that if they get him stabilized in his levels with a hospital stay, it can really depend on how long it lasts afterwards. Every animal is going to respond differently. The goal is to stabilize first and then treat with fluids afterwards to keep him there. Which I kind of expected that answer. They said if he eats and drinks well, that it can go down naturally a little bit too. He stopped eating Thursday which may have made it spike too.

I just had a pet sitter who used to be a tech at a vet come by this morning so I can start doing his fluid treatments at home though. Hoping that will help the situation a little. I don't know how long I have with him but I'll do the best I can.

For the moment I'm going to monitor him and see how it goes. He has been eating again yesterday and today. Maybe not clearing the bowl, but still eating. The doctor said that is a good sign. He has another appt Tuesday night for fluids and blood again to check the level. Going to try to hold out to see how that goes and hope he doesn't crash again over the holiday weekend or I'll need to make an emergency call.

What's scary is I called the emergency vet Thursday night to take him and they told me there were no doctors on staff due to a shortage. These days you have to add to the worry you can get help when you need it! Yikes.

 

[fionasmom]

You are trying very hard for your boy and I agree that trying to handle this in a less stressful way is a good plan. Your vet tech sitter should be a big help. Just keep your eye on him throughout this. I don't know where you are, but do you have an option of another ER vet within driving distance?

 

[Ocean Planet]

The ER that is about 10 minutes away from me said they had doctors starting today. So I should be OK. Otherwise, the next closest ones are an hour away...

 

[Ocean Planet]

So I've spoken to a couple ER's. The closest ones who have the capacity to admit are an hour away. They each quoted me 3-5 thousand for this type of stabilization (lowering the sodium). The distance/money wouldn't be a big deal if i knew it would solve the problem and give me many more months with him..... I could put him through the stress and the levels could creep back up in a couple weeks putting us back where we are.

I'm thinking just to give him meds to keep him as comfortable for as long as I can. I don't think that is the wrong decision. I've gave him a great life the whole way. 17+ years is always an amazing thing for an animal.

 

[fionasmom]

Is the vet tech sitter still helping you? I absolutely see your point about how this is not guaranteed to solve anything, especially for the money involved. He has lived a wonderful life with you and wants, more than anything, just to be home and in your company.

 

[ColoradoCat]

So I've spoken to a couple ER's. The closest ones who have the capacity to admit are an hour away. They each quoted me 3-5 thousand for this type of stabilization (lowering the sodium). The distance/money wouldn't be a big deal if i knew it would solve the problem and give me many more months with him..... I could put him through the stress and the levels could creep back up in a couple weeks putting us back where we are.

I'm thinking just to give him meds to keep him as comfortable for as long as I can. I don't think that is the wrong decision. I've gave him a great life the whole way. 17+ years is always an amazing thing for an animal.

One of the hardest things to think about with an elderly cat is whether or not extensive treatment will actually help the animal or if it'll only be a short-term solution. I think the decision you're making is a very kind and well-informed one. I actually just checked and a cat who is 17 is in his mid 80s in cats years, so he's definitely had a good, long life thanks to your love.

 

[Ocean Planet]

Just wanted to follow up as this is kind of interesting. The past Friday when he had bloodwork, his Sodium was getting to dangerous high levels which is why they wanted me to take him to the ER. Got bloodwork again the next Tuesday and his Sodium went back down to a normal range! So, yay to saving $4 grand or so.

But, it's not all good. He was slightly anemic before and now he is a lot more now. It's crazy how in the older kitties, levels just bounce all around. Might be bad one week and good the next.

So my final decision stands to keep him comfy at home as long as I can. I've got a bunch of meds at home to try to do that. The vet visits are wearing him out and that's not fair anymore. I'll wait for him to tell me when he has had enough.

Thanks for all who replied!!