Teaka, Ckd, & A New Vet

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furmonster mom

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Well folks, I don't know how much longer our sweet momma Teaka will be hanging around with us. I think her CKD has finally advanced to full on CRF.

Teaka was diagnosed with CKD about three years ago, and we've been managing it with Aluminum Hydroxide, eggshell, and egg protein substitution (raw food diet). But last week she started vomiting, and then she didn't want to eat. I've been force feeding her for the last couple days.

Then I noticed that she was reacting to my handling of her mouth. So I put my mega strong glasses on (the ones I use for thread work), and looked at her teeth. Sure enough, they were packed with tarter.

So, off to the vet we went this morning.
It had been nearly a year and a half since we had been in last (we've lost 3 of our 5 pets, so not as many visits). There were a lot of new faces, including the new vet. Our usual vet is the founder of the hospital, and we've been seeing her for over a decade, so I'm always a little apprehensive when we visit with a new vet.

I'm happy to say that this time my fears were unfounded. The new vet took stock of the situation quickly, she listened when we mentioned all the things we knew Teaka was dealing with (including a heart murmur). And best of all, she didn't bat an eye when we said we fed a raw diet, and how we'd been managing the CKD. She suggested blood work and a urinalysis, which I expected, and confirmed that there was some periodontal disease as well.

When the vet came back with the test results, Teaka's numbers were off the charts and also indicated a UTI. I think this is where the new vet slipped just a little. She became very focused on treating the UTI and the CKD, that she didn't address the pain from the dental issues. So, while the Clavamox (I declined the Conevia injection... but at least she asked!), and the Cerenia were expected, I had to nudge her for some pain meds. Even if Teaka doesn't pull out of the CRF spiral, I don't want her to be in pain because of bad teeth. The vet adjusted quickly enough, and suggested Buprenorphine. Now, I did have one cat in the past that reacted badly to Bupe, but I'm willing to give it another try.

I am hoping that we can pull Teaka out of the spiral, but it will be an uphill battle, as they say. She's lost a lot of weight, her heart murmur is advanced (and the periodontal disease could be contributing to that), she has infection, and she is drinking and peeing like a horse.

We could use some good vibes, my friends.

 
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furmonster mom

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Thanks so much
It means a lot that I can come to a place where people understand these things.

Teaka ate a little of her breakfast on her own, but I'm still forcing the majority of her meals on her. I try to take it in small portions, giving about 20 minutes between each.

She has not had a reaction to the Bupe, and she was a little more active today, so I feel that is an indicator that at least her pain is managed.
I expect it will be a few more days until the antibiotics really have any effect.

Thing is, since her kidneys are not filtering well, the byproducts of the meds could just be adding to the systemic build up... making everything a bit counter productive on that level.

Still... I can't help but at lest try to make her at least as comfortable as possible. I can give her that.
 

duckpond

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Im glad she is feeling a little better today! Pretty girl, we are all in her corner, cheering her on! I will keep her in my thoughts and prayers, do continue to let us know how she is doing! :cheerleader:
 

Mamanyt1953

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A tiny triumph in the middle of it all. Teka is feeling a little...if not "better," then less uncomfortable. Thinking of you both!
 
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furmonster mom

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A little more improvement today, she actually ate some of breakfast and dinner on her own. Still had to force the rest of it, but I'll take any victory for now.

The vet's office called to check on her, and I had a conversation with the tech about how the meds were only for a week (usually antibiotics are for two weeks). I think perhaps it was because the bupe is tightly controlled and they can only give a week of that at a time (?). So, they just prescribed the antibiotics to match. The tech didn't really know, so it's just a guess because otherwise it just seems weird. Anyway, we scheduled a followup for Wednesday.
 

silkenpaw

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So glad you got Teaka to eat. I think you are right about the buprenorphine. They don’t want people using it on themselves, so they’ll give you only so much at a time. If you think it really helps her, I would keep nagging them for refills.
 

Mamanyt1953

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I'm a huge believer in celebrating the small victories! SO HAPPY to here that she will eat anything at all on her own!
 
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furmonster mom

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So, after I scheduled the appointment, and confirmed via text, I got an odd phone message from one of the vet techs ... something along the lines of; "We are going to refill the Clavamox (antibiotic) because we just didn't have enough on hand during your last visit. But the buprenorphine was just a temporary medication, so we don't plan on refilling that. You shouldn't need to come in for another week after the antibiotics are done."

Uhhhmmm... the Bupe was for the teeth, which are hurting her, which is making it difficult for her to eat, which is causing her to lose weight, which is the exact opposite of what we need right now. The teeth have not been, as of yet, dealt with... hello!!

So I went in to the office in person. Where I saw one of the ladies who's known me since we first started going to them (15 years). As I explained the situation, the gal had to take a call. Then I saw another assistant that I knew and asked to speak with the senior tech (who we've also known for years). Just as the first lady at reception finished her call, she said "you should probably speak with..." and the senior vet tech came out, "her, yes, you got it". We all had a little chuckle at the timing.

Once again, I went through the points with the senior vet tech: the kidneys, the infection, the teeth... She looked at me and asked, "Is the Bupe helping?"... my answer was affirmative, and she very calmly said "okay, I'll have it ready for you this afternoon".

I tell ya, it pays to have a good relationship with your vets and the techs. All the ones who've been there know that I am not the kind of person to abuse medications, and they also know that I do my research and wouldn't ask for something unless it was really necessary.

We will go back in next week, and depending on her kidney values and the infection, we'll talk about what we can do about the teeth.

So, Teaka has been floating along. She shows interest in food, but I still have to help her out with it. She has gained a pound back and is comfortable enough to hang out in the main room with us.
 
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furmonster mom

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It's hard to tell sometimes if she is improving, or just hangin' in there; so I just focus on giving her loves and letting her relax through the day.
 
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furmonster mom

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*sigh*
Meal times have become a bit of a chore. I've literally had to force every bite of food into her mouth.

We have a vet appointment tomorrow morning, so if the kidney numbers indicate that she can handle the anesthesia, we'll discuss dental options. If not, it just may be a matter of making her as comfortable as possible for a while.
 
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furmonster mom

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Unfortunately the vet visit did not go well.

As they were getting a sample from her bladder, they put her under a ultrasound and made a discovery... Teaka has a mass right in the middle of her bladder.

Due to the placement, there was no way we would have ever known about it. It's not blocking any of the "in" or "out" valves, so the urine literally just flows on around it. It does cause a bit of "tiny bladder" syndrome, but we were just chalking that up to the kidney issues.

Unfortunately, this discovery changes the game entirely, as this kind of mass is considered to be very aggressive. We could try to get it removed, but with her kidney values still pretty far out, her chances of survival are slim... and then there are still the teeth.

With the fact that just eating, which is kinda important to living, has literally become a fight for every bite, we've had to accept that these are her last days.
We are doing everything we can to keep her comfortable and giving her loves before she crosses the bridge.
 
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furmonster mom

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Thanks guys.... we have her for a few more days at least

I can try to spoil her a little with some salmon, but even that might be a tough sell.
 
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