Update On Neil And His Health

[ameliashuman]

So we took Neil in one week after his acute renal failure crisis. Kidney numbers are back to being high, he's still anemic, and still dehydrated. The vet suspects there's something going on with his bone marrow, maybe the lymphoma? Over the weekend he did okay initially, but slowly decreased his eating and started vomiting again on Sunday. We've decided to treat his symptoms and not do additional testing since it would be more for our knowledge rather than pursuing more intensive treatments. The chemo and doing a biopsy would be so stressful for him and in his condition and a three hour car ride for the specialist/chemo, I just can't see it leading to a good quality of life. Hopefully we're making the right decision, I second guess myself sometimes, but then I just think about his shaking and crying at the vet and I can't imagine doing that to him for 3 hours + the hours in the vet office.

So we've been taught to do subcutaneous fluids and B12 injections at home. We'll regroup with the Vet in 10 days to see if this worked. Will be taking a deep dive into the forums for advice. He also has a Grade III hear murmur so we apparently need to be careful not to put him into congestive heart failure with too much fluids. Any threads I should read/websites good for helping with subQ fluids?

 

[FeebysOwner]

Hi. Neil is very lucky to have you taking such good care of him! I can't offer any personal experiences, but maybe until other members come along and give you some first hand information you can look through these previous TCS threads for some guidance?
Search Results for Query: sub-Q fluids | TheCatSite

Also, if you aren't aware of this web site, it might be helpful - although I am not sure what level of heart failure involvement you might find.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

 

[mrsgreenjeens]

It's definitely a fine line giving fluids to a cat with heart issues, but if you follow your Vet's advise on the amount, you should be ok. I'm guessing they told you to give smaller amount, but more frequently?

as far as tips, I would suggest warming the fluids, you can do this by putting the bag in a sink or bowl of hot water for several minutes. Also, the higher you can hang the bag, the faster the fluids will run, which in our case was a good thing because our cats got antsy during the "procedure". We also found it helped a LOT to warm up a big towel in the dryer ahead of time to wrap up our furbabies in to help keep them warm while getting their fluids No matter how much I warmed up the fluids, they still seemed to make the cats "shiver" and the warm blanket helped. We used Terumo 20G needles as we found them to be the best ones around, and the needles just seemed to slide right in. If Neil is a lap cat, he might let you give him his fluids while he's laying in a lap and never even "complain" about it. Other cats need to be semi restrained by being held down...some can be kept busy eating treats or a meal. Don't be afraid to give him these much needed fluids. Remember, you are helping him, not hurting him. It may seem daunting at first, but once you do it a time or two, you'll wonder why you were worried

That last website listed above was my go to for anything kidney related and they do have many hint on giving fluids, including where to buy supplies. Here's a link to the section on fluids: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Fluid Therapy.

Let me know if you have more questions. We're here to help.

 

[ameliashuman]

Thank you for these suggestions, I like the idea of using a warmed blanket. He's more of a sit by your side or force you to lie down so he can sit pressed up against your head sort of kitty. But I think having something warm around his body may work.
We're doing 150 ml every three days, based on the research this seems like a higher amount given less frequently, but the vet thought based on how he responded to fluids last week this would be a good schedule. Now that I know more about schedules of administration I can ask a few more knowledgeable questions. We go back in 10 days and will also be carefully monitoring for signs of congestive heart failure.

One question I have, he got his B12 injection yesterday and fluids yesterday. However, he continued to be pretty lethargic and didn't come out for pets at all. This morning he avoided me (but he also knows I give him an antibiotic in the morning so maybe he was just sick of all the poking/prodding/squirting stuff into his mouth?) He ate much more than he had the past few days (4 oz of wet food and 2 oz of tuna!) so that's good. But it seems like other cats with B12 and fluids get an increase in energy right afterwards. Am I being unrealistic in my expectations? Does it take a few times before you see some return in energy?

 

[mrsgreenjeens]

Since he has so many issues right now, I'm not sure that simply getting his B12 shot and fluids would result in immediate improvement. But eating well is definitely a good sign! My babies ONLY had kidney disease, and it was chronic, not acute. That makes a difference also. Even though it doesn't sound like it, ACUTE is actually worse and normally requires hospitalization, but if they can get over that, it's a good thing. With Chronic, it's forever . Do you know what caused the Acute Renal Failure? Did he get into some sort of poisen or anti freeze or something like that?

Anyway, it's hard to say exactly what is causing his lethargy. How bad is his Anemia? That could certainly be contributing to it? Is he getting anything for that other than the B12?

 

[ameliashuman]

His kidney levels have been elevated since February, the vet at the time thought it was early stage CKD. In May, Neil had started vomiting bile, decreasing energy, and was decreasing his eating and the concern was IBS vs. Lymphoma. Last weekend the vet thinks Neil went into kidney failure after he got a kidney infection. So its just been a slow decline until last weekend when it all crashed

I don't have my numbers from Tuesday but they weren't so different than our results on 8/28, just slightly : RBC is 4.42, Hemocrat is 15.7, hemoglobin 5.7. What treatment options are there for anemia besides blood transfusion? Right now our medicines include: Benzopril for HTN, Mirtazapine every three days for appetite, a wide spectrum antibiotic BID, a more narrow spectrum antibiotic injection, cerenia PRN, buprenex PRN, and now weekly b12 injections, and subQ fluids every three days. He also has a B12 vitamin that's not likely useful with the injections, but he LOVES this vitamin. Even at his worse last weekend, he ate the vitamin.

 

[white shadow]

What treatment options are there for anemia besides blood transfusion?

Blood transfusion would be a last resort. But, there are others....

Don't let this overwhelm you - a skim through would give you a sense for it, though: Tanya's Guide...Anaemia - Treatments.
.

 

[ameliashuman]

Blood transfusion would be a last resort. But, there are others....

Don't let this overwhelm you - a skim through would give you a sense for it, though: Tanya's Guide...Anaemia - Treatments.
.

Tanya's guide has so much info, I missed this page the other day! Will bring the suggestions to the vet next week! Thank you

 

[white shadow]

.
You're very welcome!

It's so easy to get lost in there! I've been using it for many years, so perhaps it's a little easier as a result. The "Symptoms" page has an alpha list that's especially useful - and most of it applies universally, not just kidney kitties.

Anyways, just ask......lol!
.

 

[mrsgreenjeens]

Why is he on pain killers? I see they are to be given PRN, but what kind of pain does he have? I'm wondering if that could be a reason for his dehydration. I know whenever I take one of my opiod pain killers, I get pretty dehydrated, even though I drink more water with them.

As far as his Vit. B12 treats, I doubt they could hurt him while he's getting B12 shorts, as long as they don't contain other vitamins too. Cats with kidney issues shouldn't get too many of certain vitamins, but the B's aren't the ones

 

[FrankieNMurphy]

My cat nearly died from acute kidney failure - seemed to happen almost overnight.
I was a vet tech at the time, so my vet did blood work and said he had about 1 month left.

I bought Sub-q fluids, needles, and venosets online, and next month, the vet was stunned that his blood work was 100% normal. It took a few days on the fluids, but he started to perk up after that.
With that regime, he lived to 21 years old. (he was 15 when diagnosed) DON"T give up! It is a heartbreaking disease in our kitties - and all too common.
I gave him 100ml every other day for 3 years, then every day after that, until he said he wanted to go. He got B-12 shots every 3rd day for all those years.
I hope and pray your little baby will get better soon.

 

[ameliashuman]

Mrsfreenjeen: they thought he may have had pancretitis back in july and he was doing things like hissing at nothing and isolating. We haven't given that med since the week before his renal failure. I was worried about constipation.

FrankieNMurphy:. What an inspiring story, thank you!

 

[MissClouseau]

Cats with kidney issues shouldn't get too many of certain vitamins, but the B's aren't the ones

This got me curious - which vitamins are the risky ones when taken too many? Hima's vet told me all cats should be careful with Vitamin A and E as they are stored in the body. Is there anything else?

 

[white shadow]

....which vitamins are the risky ones when taken too many? Hima's vet told me all cats should be careful with Vitamin A and E as they are stored in the body. Is there anything else?

A primer for you: Tanya's Guide.....Vitamins

Actually, waaay more than a primer.....as is usual with all-things-Tanya, it's comprehensive !
.

 

[ameliashuman]

Whoever Tanya is, she's developed an amazing resource!

 

[white shadow]

Whoever Tanya is, she's developed an amazing resource!

In her own words: Tanya's Guide.....A Bit about Helen

Helen and her cats: My Three CKD Cats

Her first site: HARPSIE
.

 

[mrsgreenjeens]

This got me curious - which vitamins are the risky ones when taken too many? Hima's vet told me all cats should be careful with Vitamin A and E as they are stored in the body. Is there anything else?

Did you get your answer? white shadow provided you with that great link, which gave your even more information than I had. I was just going to say A & D.

 

[MissClouseau]

Did you get your answer? white shadow provided you with that great link, which gave your even more information than I had. I was just going to say A & D.

I did, thank you!

 

[ameliashuman]

So Neil's eating is consistent and he's coming in for cuddles at night (though is still a bit lethargic compared to his former self). However he continues to experience a lot of nausea. The vomiting has stopped since we started giving him the full dosage be of cerenia the vet would allow, but he experiences excessive drooling.

We have a vet appointment next Friday, any suggestions I can bring to the vet or read up on would be appreciated. Our vet has been very receptive when we bring in outside ideas!

 

[mrsgreenjeens]

It could be that antibiotic he's on. Not sure which one he's taking, but those can cause not only gastric distress, but sometimes nausea. Which one is he taking? I'm talking about the wide spectrum one, not the injection. Nausea itself can cause drooling. You may be able to keep the vomiting at bay, but he may still be a little nauseated