Help:Senior Cat Question---Emergency Situation?

[LoveandMokey]

My cat is approximately 16 years, and for the past several days has been acting strangely---sleeping TOO much, case of the wobblies/messed-up eqilibrium, this latter due to dilated pupils which I am now afraid is going to leave her blind. Took her to the emergency vet today and he stated she was dehydrated, gave her injection of fluids and she has been drinking---moderately---and eating very near normally. I am worried she (and I) can't wait out Sunday and Memorial Day to go to the regular vet for blood work. If this is kidney failure or hypertension or something else, can we wait until Tuesday or should I take her back to the emergency vet? Thanks for any and all advice

[Traci]

Since the symptoms have been present for several days, I wouldn't wait til Tuesday. Can I ask why the emergency vet today didn't offer you bloodwork etc? I assume he felt she was dehydrated to warrant fluid therapy, but in a 16-year-old kitty, you really do need to get bloodwork done to check liver, kidney and heart function.

I wouldn't wait. If the symptoms had only been a day, it may have been able to wait, but it's been several days, and the wobbliness and equilibrium and dilated pupils are truly concerning. You can call the emergency vet prior and get a quote on costs for labwork, etc, but I'd get her in ASAP.

[LoveandMokey]

Thank you so much for the quick reply, I'm going to take her in.

[Traci]

I think you'll have peace of mind for doing so. Given her age and the symptoms, you really need to rule out kidney, liver, heart function. Try to get a FULL bloodwork profile done for her...treatment will depend on what the bloodwork reveals.

Update us when you can? I'm hoping it's nothing serious...

[LoveandMokey]

Thanks again for the solid advice. We went in early on Sunday and she got bloodwork and a couple other tests done. She's got renal failure, hypertension, hyperthyroidism (I think that's what the last is called), and detached retinas. So, basically, the works. I'm taking her to the regular vet tomorrow; in the meantime we've been just taking care of her at home. We've got her on Norvasc (for one of the "hyper-"s), and she's eating and drinking to near her normal levels. The vision thing has naturally messed her up, but despite her tentativeness and bumping into things, I think she's adjusting (she still has some pupil movement, so we think she can detect some shadows and light). We're going to do all we can for her to make her comfortable, whatever that might enatil; my biggest worry is the kidneys, since I'm still not sure how manageable that is (and now much damage there is exactly, too).
She's walking around right now, and can still get to the litterbox; we bring food and water to her, or her to it. It's been a painful few days, but again, thanks for the sound advice. It feels worlds better to now what's going on with her and to be actively trying to help her.

[Tambrey]

the norvasc is for her hypertension...high blood pressure...which affects negatively on the kidneys...my husband and mom both take Norvasc also...

my husband has a kidney disease and is on a low protein diet...your vet will probably do similar for your cat...plus the meds to keep blood pressure in check, and most likely also add something for the hyperthyroidism as well...I took tapazole when my thyroid was out of whack, but I am not sure if they prescribe that for critters as well...

good to know what you are dealing with and can plan from here on out to ensure she is comfortable and enjoys the rest of her days!!

[Traci]

Do be sure to get her seen by your vet ASAP, and have the other vet fax her bloodwork results to your regular vet first thing, your vet can then try to determine if she may need to be on IV fluids to help flush the kidneys (this usually requires a day or so of hospitalization). Renal disease and hyperthyroidism oftentimes go hand in hand, especially in senior kitties, but it can most often be treated and managed if caught early and treated agressively at the onset.

The hypertension probably caused the detached retinas (as a result of renal insufficiency), your vet can adress that further with her medication, as well as perhaps check her overall heart function (i.e., with an ECG). If the other vet did a thyroid panel (T3 or T4) to confirm hyperthyroidism, then your vet may want to start kitty on methimazole (tapazole), but be prepared her thyroid levels will need to be checked frequently within the first 3 months or so, so that the medication can be monitored and adjusted accordingly. You'l want to follow up with your vet frequently to monitor her bloodwork and organ function, especially in the first few months.

Sub-q therapy might be required on a regular basis, your vet can discuss this with you so that you can give them at home. He'll probably also suggest a veterinary prescribed renal diet low in protein/phosphorus/sodium, do be sure to heed his advice. While renal failure cannot be cured, there is treatment to help slow the progression and manage it. Don't leave your vet's clinic without getting all your questions and concerns met.

Keep us updated if you can?

[LoveandMokey]

Thanks to both Traci and Tambrey for your replies. She's at the regular vet's now, awaiting the fax from the emergency place. This vet I'm seeing now is new, but so wonderful with Mokey and helpful with the situation and all my questions. What she outlined is basically what both of you mentioned/recommended: the condition-sensitive diet, the monitoring, the at-home kidney-fluid treatment (kitty dialysis), et al. Since the trip on Sunday, Moke has been relaxing at home and I think if we can maintain her health and fluid levels (no heart murmer, thank goodness) she will adjust to all this.

The tricky thing is the balance between the treating the thyroid levels, since this causes less (or just back-to-normal) blood to support the kidney function, but I'm hoping that this will work out.

I have to say thank you to those who started, run, and contribute to this site. It has been, and still is, a wonderful place to find, especially throughout this whole painful ordeal. I am so grateful to see other people who care and are concerned about our furry best friends, and have taken the time to help individuals with such upsetting circumstances. Thanks again, and I'll keep updating on Mokey's progress.

[Traci]

Depending on her current thyroid levels will depend on the thyroid medication dose and her response to it. Your vet may suggest starting her out on a very low dose, but will require frequent monitoring to ensure the dose is appropriate for her particular needs. It may need to be adjusted at some point, but this is the reason for the monitoring and rechecking thyroid levels. You'll also want to re-evaluate the hypertension, but with supportive treatment and managing the renal disease, the hypertension problem may resolve with treatment.

I'm so glad you got Mokey seen when you did. I know this is all overwhelming for you, but don't get discouraged, listen to your vet, and follow his/her directions carefully, follow up as he advises on bloodwork, etc. Maybe even keep a daily log of sorts at home to monitor her progress, medication etc, sometimes this can be helpful when adjusting medication doses etc.

[LoveandMokey]

It turned out that Mokey does [i]not[/i] have hyperthyroidism, but so far the kidney condition and hypertension have been wonderfully manageable. Right now she is on Norvasc for the hypertension and powder meds with senior food to help her process potassium and protein. We give her sub-q fluids every other day, which is really the biggest change, but we've settled into a routine with it, I think, although now that she's regained some weight and spirit, she's stronger when fighting back during sub-q time, but that's been ok. Other good news is that her pupils have basically returned to normal and her sight seems restored (I forgot to ask the vet about this at her follow-up, but am of course just relieved that it's occured, whatever the bio/technical explanation).

She is really back to her old self, if only a bit milder, maybe, and she has really adjusted to the new regimen. Barring anything else major, we're scheduled for a follow-up in 3-6 mos, and I guess the lesson of this experience for me has been to trust my instincts (about unusual physical behavior), as well as finding a vet we both trust and asking questions/for help when I need it (ok, lessons).

Thanks again!