My Old Girl With Kidney Disease...

[kittypa]

has decided that she is tired of being poked every night and taken to the vet. It’s really becoming a chore, and it saddens me that she is hiding when she would usually be demanding lap time.

I don’t think there is an answer here, more like choices. I could be wrong or just wrong headed.

Insights, experience, or ideas would be appreciated. Thank you.

~Peace~
kp

 

[denice]

I am so sorry. I have just started down this road with my older girl so I have no personal experience. The decision about when enough is enough is a hard one to make. I just did this for my IBD kitty this past January. They always say that you will know. In the past I have struggled with the decision but this time I did know, didn't really make the decision any easier.

 

[duckpond]

Such a very hard place to be in, and decisions to make. I do think there comes a time where more treatment reduces the quality of life to the point where it becomes bad rather than good. If there is a chance for recovery and a lot of happy times left, then yes we continue. With our senior cats, and something they will not recover from i guess sometimes we need to work to give them the best of the time they have left, rather than prolong life for as long as we can. It hurts so bad, but sometimes letting go is the Kindest thing to do. I have not had to do this with one of mine , but everyone i know says that you will know when it is time.

I would work with my vet, i trust mine to give me the advice i need. Can we just control any pain, nausea, ect... give her foods she likes, keep her home, and let her enjoy as best she can the last of her days? Some pass naturally when its time, some we must make the decision for, if it comes to that hopefully your vet will come to your home to make it easier for her?

Sending both of you hugs. I wish i had words to make it easier, but i just dont. But know my thoughts are with you both!

 

[mama africa]

I'm very sorry, kittypa .
(Un)fortunately I have no experience with a cat with (chronic) kidney disease; I hope that other members can give you some good ideas and insights.
I'm keeping Checkers and you in my thoughts.

 

[Furballsmom]

Hi! You are familiar with the articles library here, Tanya's site for kidney cats and also Tanya's kidney cat support group?

 

[tabbytom]

kittypa , I'm so

to hear this about your girl and I can't be of any help here as I know nuts about this ailment.

Just giving you support to you and your girl. Hope she gets better.

girl!

 

[mekkababble]

Hello kittypa

How old is your cat and what is percentage of her kidneys are functioning?

My cat with CKD lived to be 21 years until I finally had to put her down. She was diagnosed when she was in her early teens and had a happy life. We treated her first with: a prescription kidney food, followed by phosphorous binders in her wet food, antibiotics for chronic UTIs, and finally morphine and fluids until she too just had enough. Up to the last, she ate, purred, and did what she could to be around me (she hung out in the kitchen where there was plenty of activity, food, and a heat vent) but in her last month just wouldn't move unless I picked her up and even that hurt her. I still feel terrible because I suspect she was anemic too and therefore always cold, suffering from nausea, etc. I'm sure all of this sounds familiar to you.

I went back and forth multiple times per day when I should put her out of her misery and finally called the vet the day I found her peeing nothing but blood on the kitchen floor- that's when I decided that I was keeping her alive for me more than her and that I owed her a final kindness.

It's cliche to say that your cat will tell you when it's time, but I do think it's true. One exercise I found helpful was to make a list of your cat's 5 favorite things to do. How many is she still able to engage in? How many good days does she have vs. bad? These are some 'objective' measurements you can use to determine your cat's quality of life, but obviously you're going to know her the best.

Euthanizing your best friend is by no means an easy thing to do and it still hurts me that I don't have my Shade. I regret doing it but at the same time wouldn't have waited any longer or denied her the peaceful end I was privileged to give her.

I'm happy to talk to you and answer any questions you have about managing the final phases of CKD.

 

[kittypa]

She is 16 years old. We’re in the early stages (stage II) and we are not thinking euthanize yet. The question at this stage is how aggressively can we treat her. Things we’re fine for the first 10 days or so, we gave her fluids every night. Suddenly she started hiding. I suspect that she just got tired of being poked, although it’s possible that she feels that bad. She’s eating, but she’s not showing up for lap time like she normally did in the morning and evening.

So here we are. I can treat her aggressively, force her to sit for fluids every evening then she spends the rest of her life hiding from us. Or we ease up in which case she will be happier now, but we will lose her much more quickly.

It’s just difficult to decide.

 

[Furballsmom]

she will be happier now

In my thinking, this is your key...

I'm not trying to be a person who says it but hasn't walked that road, previous actions on my part bear it out. I simply couldn't let my sweet Maine Coon go on any longer, it was more stress than she could deal with, and to me that was worse. --even though I got some pushback from others about it.

 

[denice]

My girl was just diagnosed with Stage II. She is just getting the prescription food at this point, the vet didn't think she was at the point of needing fluids. There will be more trips to the vet for blood draws and weight checks. As a senior she was going every six months, it will probably be every three months for the foreseeable future. It had been close to a year since she had been to the vet because of what went on with Patches at the beginning of the year. I should have kept up with her as well and this would have been caught earlier. She had always been my healthy one except for problem teeth.

 

[Furballsmom]

 

[mekkababble]

She is 16 years old. We’re in the early stages (stage II) and we are not thinking euthanize yet. The question at this stage is how aggressively can we treat her. Things we’re fine for the first 10 days or so, we gave her fluids every night. Suddenly she started hiding. I suspect that she just got tired of being poked, although it’s possible that she feels that bad. She’s eating, but she’s not showing up for lap time like she normally did in the morning and evening.

So here we are. I can treat her aggressively, force her to sit for fluids every evening then she spends the rest of her life hiding from us. Or we ease up in which case she will be happier now, but we will lose her much more quickly.

It’s just difficult to decide.

How aggressively you treat her will depend on you and your cat. If she's only Stage II, I can't see giving her fluids every day unless she really suffers without them- turns lethargic, refuses food, won't drink water, etc.

Have you confirmed with your vet if you can reduce the frequency of the fluids but increase the amount she gets with each sitting? If she's able to resist getting the IV, I think your cat is still in pretty good shape. Lessening the frequency will make her less skittish too, I imagine. Try giving her treats during. I found that helped a lot.

If you're not doing it already, you may want to consider phosphorous binders for her food or a prescription diet which will slow kidney deterioration and treat UTIs as they come. I agree with you that the more conservative treatment, the better off the cat is (fewer vet visits, painkillers when needed, etc). The less stress the cat is in, the better she'll do. Even if it means fewer months in her life, the time she has left will be happy.

 

[mekkababble]

PS- I reread my statement and I'm not saying your cat only has a few months left. If she's Stage II, you'll hopefully have many more happy years with her.

 

[1CatOverTheLine]

.
kittypa - I'm sorry to hear this about Checkers. I'll preface this with the caveat that I'm (personally) not in favour of long-term palliative care either for Humans or for companion animals. I dislike the idea that discomfort is being made part and parcel to everyday Life.

I'm a staunch believer in aggressive care when it isn't simply palliative, however, but solution-based aggressive care for kidney disease, thyroid problems et al always comes with a price, and in many cases, there's a balance which must be struck.

At sixteen, assuming Checkers to be free of other medical problems (beyond the typical concommitant renal-induced hypertension, of course) and assuming her baselines to be within bounds for her age, she's probably a candidate for cure rather than treatment. Not knowing financial constraints, her general disposition and activity level, and whether there's, "room for one more," with Peko, Bootsy and Figgy, I can't make any suggestion beyond my own narrow opinion.

Within the confines of most university veterinary medical programs, owners who opt for renal transplantation must afterwards assume stewardship for the cat who becomes the kidney donor, as most donors are sourced by the university staff from high-kill shelters, which means that one is saving two Lives in the end. Complete cost is about what one would expect - in the $12k to $15k range, including cross-matching, surgical time and follow-up. Raw success rates today range in the eighty-fifth to ninetieth percentile on average for cats at six months after surgery, owed to the fact that kidney transplantation in cats is extremely straightforward.

This article is two and one-half years out of date, and we've made significant progress in those thirty months, but it's concise, succinctly written, and addresses most transplant concerns with clarity:

The Ethics of Kidney Transplants for Cats | petMD

Give Checkers ah hug for me, please.
.

 

[kittypa]

Thank you all for your replies. It is really appreciated. I've decided to do as much treatment as we can and still be reasonable with Checkers. At her last checkup, her BUN # had come down some, but the creatinine still crept up a little after treatment. The vet want us to continue the sub q treatment daily for another week to see if we can get some improvement. Since we're in the early stages, I'm leaning toward treatment right now, and hoping we can do some good. I will be asking some questions at our next visit to the vet, based on some things I've read here.

Thanks again
~Peace~
kp

 

[Furballsmom]