My cat's CKD and UTIs are exhausting me

BigBurgers

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My cat has stage 3 CKD which I've been mostly keeping under control with her diet and sub-Q fluids at home. She gets frequent UTIs (I've posted about them here before) and is currently dealing with another, and she's also being treated for hyperthyroidism (numbers are good). This past spring we ran a culture on her urine which turned up a type of bacteria (forget the name) which the vet told me is quite common and usually doesn't cause issues, so since then we haven't been treating her with antibiotics whereas in the past we always did. After this recent run of blood/urine work they discovered her creatinine is above 7 and her urine has a very high level of bacteria. We've dealt with dangerously high numbers before. Last fall she became very ill, likely due to an unchecked UTI which made it to her kidneys. With meds, fluids, and forced feeding I was able to get her creatinine back into the 3 range. Those high numbers would suggest kidney failure but she doesn't show any other physical signs of it. No bad breath, no excess weight loss (weight has been stable at 5.8 for months), solid thirst and appetite, active and playful, jumps up on the windowsill with ease.

The current problem I'm having though is her obsession with water. She has a nasty habit (encouraging bad behavior on my part) where she will only drink if I swish her water or my finger is in her dish, or I have to run the bathroom faucet, and she won't touch her fountain anymore. Now she's waking me up several times in the night for me to swish her water. She'll take 5 laps from the dish and run away. It's affecting my sleep and overall daily productivity because I'm a zombie. My hope is that this new water obsession has more to due with her UTI than her kidneys, because since last Fall she's been getting 50-100~ml of fluids at home almost every day. She's only just gotten her 4th dose of her oral antibiotic so I've got a few more days before I might notice any positive changes.

Has anybody dealt with this before and have any suggestions for me on what to do? If this continues my next step might just have to be locking her out of my bedroom and wearing earplugs as I sleep, but that might only make her scratch at my door and meow louder. Any suggestions would be great!
 
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Furballsmom

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Try a different fountain such as the pioneer pet swan neck fountain, and float a clean pingpong ball or clean fishing bob/float in the bowl so she can see the surface of the water more easily.

Also have a couple clean daily tall water glasses or mason jars filled with fresh daily filtered water in a couple of unusual locations around the house.
 
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BigBurgers

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Thanks for the recommendation, I immediately purchased that fountain along with some glow-in-the-dark ping pong balls. This will actually be the third fountain she's had, but from the looks of it it might just be what she'll like. Will report back!
 

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BigBurgers

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I did! Though I don't think I gave it to her long enough to see any benefit. We established care at a new vet and her bloodwork showed elevated ALT, so the vet wanted me to pull her off all supplements and check her blood again a month later. The ALT dropped a bit and I haven't put her back on any supplements, but after her past couple of labs I've been meaning to put her back on it. I like the looks of this product you linked to more than the one I was giving her before....so I'll purchase this too!
 
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BigBurgers

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Just to add, I'm hopeful that the new fountain will do the trick but the bigger problem is mainly breaking this dependence on me to swish her water or run the faucet. Usually, in the first half of the day, any movement from me triggers her to run to the dish. Getting up from my computer chair, going to the kitchen, anything. She'll sit there and meow until I come over and get down on the floor to put my finger in her water. Even then, sometimes she drinks but other times she'll stare at the dish for a moment and walk away, or run to the bathroom instead for me to turn on the faucet. It seems innocent enough, but when she's waking me up 3-4 times a night to do this it gets exhausting. I haven't had a solid night of sleep for a couple months. That said, since the weather has been so hot I will occasionally put an ice cube in her dish, and sometimes I've found that she'll favor that over my finger......so maybe the ping pong balls will do the trick? Either way, I'm hopeful that this new obsession is just due to her UTI.
 

Furballsmom

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so maybe the ping pong balls will do the trick?
I'm SO hoping!! Bless her little heart, "--but sweetie, your person needs sleep!" :vibes::hugs:

Oh by the way, that fountain has an adjustable little slider door so that you can have more flow or less flow. I had to adjust the flow down a fair bit because Poppycat was inhaling air and water due to too much water coming out.
 
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BigBurgers

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She was intrigued by the fountain and drank from it a little bit. At first she was sticking her head right in the dish but getting hit by the faucet! This is her afternoon slump so she probably won't drink more until this evening. Fingers crossed!
 
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BigBurgers

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On a related note, can UTIs cause disorientation? I've been noticing that sometimes she seems to be totally with it, but other times she acts a little disoriented like she doesn't know exactly where she is. For example, she didn't want to jump down from a ledge that she's used to, and I moved a water dish a few feet away from her and she couldn't find it. This is new behavior. At the same time though, she still eats and drinks, and at the moment she's sitting near me cleaning her paws because I just clipped her nails. This is usually her down time, so it's possible she'll perk up later, but it's my understanding that a nasty UTI, especially in an elderly animal, can cause some disorientation?
 

Furballsmom

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When is the last time you had her blood tests done? Maybe do another in case something is getting out of whack that might need addressed?
 
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BigBurgers

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Just a couple of days ago. Coincidentally, this is occurring right in line with her routine 4 week checkups. It started with vomiting and diarrhea on Thursday night, then again on Friday night. Friday though we started the course of antibiotics, so as of writing this she's had only 4 doses and will be receiving her next one in a couple of hours along with 100ml of subQs. Throughout the day today she seemed just fine.

I just gave her a fresh dish of food. Held it over her head and she perked up, stared right at it, eyes got wide. Now she's gobbling it down.
 

epona

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On a related note, can UTIs cause disorientation? I've been noticing that sometimes she seems to be totally with it, but other times she acts a little disoriented like she doesn't know exactly where she is. For example, she didn't want to jump down from a ledge that she's used to, and I moved a water dish a few feet away from her and she couldn't find it. This is new behavior. At the same time though, she still eats and drinks, and at the moment she's sitting near me cleaning her paws because I just clipped her nails. This is usually her down time, so it's possible she'll perk up later, but it's my understanding that a nasty UTI, especially in an elderly animal, can cause some disorientation?
In very elderly humans, UTIs are well known to cause temporary periods of confusion and cognitive issues or to exacerbate those issues if they exist as a result of other causes. I don't know whether it is the same in cats, but it honestly wouldn't surprise me.
 

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My cat is fussy about water too. She likes to drink from my water glass on the bedside table and likes me to hold it at an angle when she drinks. If I don't she will knock the glass over. I bought one of those glasses that is round on the bottom so it just wobbles around when she knocks it with her paw.
I don't know how to stop this kind of behaviour though. My cat is very stubborn and it sounds like yours is too.
 
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BigBurgers

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Yep, she's very stubborn. As I type this, she's sitting behind me next to her water dish, alternating between staring at the water and me. Last night was pretty bad, she woke me at 4, then in intervals throughout the night. I'm an absolutely zombie and don't know how much longer I can live like this.

On a positive note, though, the vet was able to squeeze her in yesterday because lately I've also been noticing her eyesight might be diminishing. The vet suspected and confirmed high blood pressure, so I just started her on a blood pressure med (on top of her thyroid med, antibiotic, fluids, and now d-mannose). She's put on a half a pound of weight in a week and overall she's doing quite well, and any eyesight she's lost will likely return. The vet also gave me gabapentin to try before bed, putting her on a low dose to hopefully calm her down throughout the night. It didn't work, unfortunately.

My hope among hopes is that so much of this nightly water obsession is because of this oppressive heat and humidity we're experiencing in the midwest. I run an air conditioner in my bedroom, but she chooses to sleep either in the living room or my office which are at least 10 degrees warmer plus humidity. Coincidentally, most of this behavior has really only been happening over the past couple of months when the temps really shot up.

If nothing improves, my only real option is to lock her out of my room and wear earplugs. It'll kill me to do it, and she'll raise a storm by meowing and scratching at my door, but I don't know what else to do.
 

Furballsmom

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By the way, I apologize I don't recall but did you have a chance to try a mason jar or tall water glass?
 
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