Hey, folks! I was wondering if anyone has advice for, or experience with, caring for a cat with kidney and liver problems. Also, my keyboard is having issues with the "a", "e", and "d" keys, so please ignore any missing letters!
A bit of background an' such-
Perni is six and a half years old, tho' he's "physically older" due to his health problems (vet says we should consider him to be twice his actual age). We've had him and his three sisters since they were about two weeks old- bottle feeding, etc., the whole deal. They and their mother (a wild, but not quite feral, cat) were ill. We managed a catch/treat/spay/release on Mom with only minor injuries to ourselves, and took the kittens into the house after their vet visit. Perni was how we found the litter; his yowling led us to them, and he gets full credit for saving his sisters. He also kept the yowling going for a full forty-eight hours after we brought him home!
Perni and his sisters are strictly indoor cats. They came from a rather inbred "colony", which likely accounts for his problems, tho' his sisters are as normal as cats can be. He developed more slowly than the girls; he has poor vision and muscle control, and has never gained weight normally.
He's been having seizures since he was one and a half. We tried phenobarbital for awhile, but the affect on his personality and energy was worse than the seizures. His seizures have increased in frequency over the years- he once had four in a month, but sometimes none for weeks, and always less in winter- and the recovery from them has begun to take a bit longer. Other than the seizures, he's been to the vet for vaccinations, neutering, and occasional blood tests to keep an eye on things (all results were within normal ranges). Inspite of his differences, he's been as cheerful, bouncy, and snuggley as a cat could be.
About two weeks ago, he starting acting in un-Pernilike ways. He began to lose what weight he had, stopped grooming as much (he's never been a big groomer, but his sisters help him), started drinking excessively, had little interest in food, began "hunching" a bit, felt cold, and wasn't leaving much in the litterboxes. Lots of bad things all at once, and very quickly.
We took him into our vet as soon as we could. His temperature was two degrees lower than normal. They gave him subcutaneous fluids, and we had one of the big fancy blood tests done. We got the results on Monday (they sent it to a bigger lab over the weekend). Basically, the good things were very low, the bad things were very high, and our Perni is left with only a small percentage of kidney function and some liver damage. No visible cause, such as toxins and whatnot; it seems to be his physical age and health problems working against him.
We kept him in the hospital on IV fluids to flush his system and rehydrate him for a few days. We would have left him longer, but he began throwing up- didn't keep anything down for almost twelve hours- and gnawing on his IV. We decided the stress of being away from home, even having his blanket and us coming in to cuddle him, was too much for him. I was also concerned about him having seizure in the kennel and injuring himself. As soon as we got him home, he stopped throwing up, and perked up.
He's been home almost three days. We're giving him a phosporus binder (1/8 tsp mixed with water twice a day), a potassium supplement (1/2 tsp once a day), Science Diet KD, and subcutaneous fluids every two days (started that today).
I'm mixing a bit of Iams in with his KD, as he'll barely touch it alone- I know it'd be better for him to stick with the KD alone, but getting food into him outweighs that. I'm also adding about a teaspoon of fat-free, no salt added organic chicken broth, to thin it. I tried water, but he turned up his nose. Without thinning it, he just pushes it around with his tongue- he's licking/lapping his food, rather than biting it.
His appetite has improved a fair amount in the last two days. He comes running in with the others when I open a can, tho' he's still eating very small amounts. We offer him the bowl every two hours. He's eaten almost two-thirds of a 5.5 oz can of KD and a quarter of a 5.5 oz can of Iams over the last day and a half. It's scary when almost one can over almost two days is a huge improvement, but it's what we've got.
He doesn't like his sub-Q fluids at all- neither do I, as I'm terrified of needles. Fortunately, Perni's Dad and I have a good amount of kitty/needle experience, so I hold and he pokes. This is the first time we've given fluids in large amounts (our vet said 150 mL at a time), tho'. We're using an IV bag instead of the large syringe we'd used before, with another kitty, so it's a bit more complicated. I'm also worried that we're going to run out of places to stick the needle in his shoulder area. We accidentally got a little air bubble under his skin today, which freaked me out a bit, but the Dad and the vet say it's fine. It's still there after an hour, but I guess it takes awhile to absorb it.
He's no longer chilly, or hunching, his fur is looking fluffy and shiny again, and he's almost completely returned to normal Perni personality and habits. He moves well; always been a bit wobbly, but he's ignoring the kitty stairs in favor of jumping on and off the beds. He even stretched up and "grabbed" my rear with his front paws yesterday- it's one of his favorite things to do when I'm in the kitchen, and he hadn't done it for two weeks.
The water bowl visits are shorter and slightly less frequent than they were. He still hasn't left anything but wet spots in the litterbox, but that's better than nothing at all. I've been wiping him down once a day with some "kitty wipes", with extra attention to his paws and between his toes. His sisters are snuggling with him, and doing some grooming for him. I'm going to take him in to have another blood test on Monday or Tuesday. I'll probably get the vet to do his sub-Q fluids that day, too, since I'm such a wimp about needles.
We know we'll lose him, and that it may be soon; we've always known he'd probably be the first of the herd to go. He's not in pain, and he's happiest at home, so we'll do everything we can to keep him comfy and happy until he goes.
So, if eyes and brains can still focus after all that- is there anything else we should be doing? Is there anything else that we should be asking the vet about? Suggestions, advice, similar experiences...all would be welcome!
Thank you-
Ori
Looking for advice- kidney/liver problems.
Re: Looking for advice- kidney/liver problems.
Absolutely see a NEW, more experienced, feline-only vet ASAP. Only going by your posts, it is rather sketchy and leaves me wondering about your vet's comepetence level.
What are the bloodwork results and which enzymes are out of range? Was blood and urine glucose checked? Was a thyroid panel done? Was a CBC and immunology done to determine why he was hypothermic, was he also anemic? What other diagnostics has the vet attempted now, OR years ago to address the health issues? Was a full oral health check done? If no specific diagnostics have been opted for all this time, personally, I feel your vet has/is failing you and your kitty.
I strongly advise you see a new, feline-only vet or veterinary specialist at once, get full bloodwork done, including urinalysis and thyroid function testing done. If an FELV/FIV test hasn't been done, get it done ASAP. Also, get a full immunology profile done that can help rule out blood-borne parasites, anemia problems, viral disease, fungal disease, hemobart, etc. Xrays or ultrasound to rule out lymphoma or abcesses or masses. ECG to check heart health and rule out cardiomyopathies. These are all useful paramaters to check when multiple symptoms are present.
The seizure activity should have been addressed years ago, more appropriately, with complete blood profiling and immunology. Leaving seizures untreated can spell disaster. For every seizure event he has, left untreated, they will become more severe, more frequent, and cause more considerable damage (to CNS, brain, vital organs, etc). The phenobarbitol could have and SHOULD have been dosed more effectively, all this takes is a slight adjustment in dosage and monitoring pheno levels in the blood. Your vet KNEW that the goal in treating seizures was to first diagnose the underlying cause, and if idiopathic, then to treat, regardless. The goal in seizure management is to control seizures so they lessen in frequency and severity. Followup bloodwork was essential then, as it is now. No more than 1 seizure in a 3-6 month time frame is the ideal goal. Yet, your vet ceased treating with phenobarbitol and did nothing else? Unacceptable!!
Was Perni ever diagnosed with liver shunting, a congenital heart defect or any other developmental anomoly? Did your vet ever persue diagnostics to rule these things out? Was Perni, his mother, or his siblings ever at risk for distemper or aquire distemper? Was nutritional deficiencies or excesses ever ruled out? How often did you have Perni fully evaluated, bloodwork done to monitor liver, kidney, heart function? Have you had yearly exams and full bloodwork/urinalyses done?
Sudden weight loss, vomiting, hypothermia, anorexia, weakness, wobbliness, etc were ALL red flags that your vet needed to persue additional diagnostics to get to the root of the problem, those options are as mentioned above and I wonder if he discussed any of them with you?
If he has renal/liver disease, do NOT use anything with salt in it, including any type of broths. When using phosphate binders and potassium supplements, you MUST followup on bloodwork frequently to ensure it is not in excess and affecting major organ function. If he is lapping at his food rather than chewing, this could be due to painful mouth such as diseased teeth, gingivitis, oral ulcers, or even nausea. Your vet should have discussed an appetite enhancer, something to buffer the stomach to prevent vomiting and nausea. If he isn't taking to the K/D, ask the vet for another veterinary equivalent diet, such as Purina's veterinary diets, etc.
The vet needed to tell you if Perni has chronic renal failure or acute renal failure, and what the liver problem is. There are various liver diseases that need to be addressed and treated specifically. Is there bile sludge? Is there hepatic lipidosis? Is there a cyst on the liver? Is there cholangiohepatitis? Did he discuss any of these with you? Did he perform specific liver testing to rule these out? Did he prescribe antibiotics for secondary bacterial infections?
You truly have to get a handle on giving subcutaneous fluids. Did the vet actually show you how to give them properly? There shouldn't be any time where air is injected, done properly this doesn't happen. It isn't unusual for the actual fluid to produce a large pocket under the skin and it can take hours for the fluid to disperse, but there should never be air under the skin. Judging by your description, if Perni is a relatively small cat, and is already severely underweight, the fluids should be divided into two parts, with 1/2 given over the left shoulder, and the other half given over the right shoulder. This not only evens out distribution of fluids, but is more comfortable for the cat.
When giving fluids, you must keep the line free from air. Hang the fluid bag on a hanger, suspended over you and the cat so that the fluid flows easily through the line. Open the clamp, let the fluid run through until you see it coming through the end of the needle. This prevents air from accumulating in the line. Do not tangle or wrap the line over anything when storing, just let it drape once over the hanger (and be sure to cap the needle or remove it and replace the end with the fluid line cap it comes with). Do NOT refrigerate a fluid bag. Before administering, place the fluid bag under warm running tap water long enough to warm the fluid inside (takes a few minutes, the fluid should be luke-warm, NOT hot). Warm fluids also are more comfortable for the cat.
Again, I strongly advise getting your kitty to a more experienced and more comitted vet. The seizures left untreated are extremely concerning, and now with renal and liver problems, you cannot afford to leave this undiagnosed appropriately and you sure cannot afford to leave this untreated appropriately! Perni deserves a vet who is committed to finding out WHY he has so many symptoms and he deserves the BEST in treatment. Don't give up on him, he's depending on you to get a qualified diagnosis and effective treatment for him. Get copies of ALL Perni's records faxed to a feline-only vet or feline specialist NOW so they can review them. Chances are, they will pick up on one or more things your current vet is obviously not addressing. Do not wait on this, see a new vet RIGHT NOW.
What are the bloodwork results and which enzymes are out of range? Was blood and urine glucose checked? Was a thyroid panel done? Was a CBC and immunology done to determine why he was hypothermic, was he also anemic? What other diagnostics has the vet attempted now, OR years ago to address the health issues? Was a full oral health check done? If no specific diagnostics have been opted for all this time, personally, I feel your vet has/is failing you and your kitty.
I strongly advise you see a new, feline-only vet or veterinary specialist at once, get full bloodwork done, including urinalysis and thyroid function testing done. If an FELV/FIV test hasn't been done, get it done ASAP. Also, get a full immunology profile done that can help rule out blood-borne parasites, anemia problems, viral disease, fungal disease, hemobart, etc. Xrays or ultrasound to rule out lymphoma or abcesses or masses. ECG to check heart health and rule out cardiomyopathies. These are all useful paramaters to check when multiple symptoms are present.
The seizure activity should have been addressed years ago, more appropriately, with complete blood profiling and immunology. Leaving seizures untreated can spell disaster. For every seizure event he has, left untreated, they will become more severe, more frequent, and cause more considerable damage (to CNS, brain, vital organs, etc). The phenobarbitol could have and SHOULD have been dosed more effectively, all this takes is a slight adjustment in dosage and monitoring pheno levels in the blood. Your vet KNEW that the goal in treating seizures was to first diagnose the underlying cause, and if idiopathic, then to treat, regardless. The goal in seizure management is to control seizures so they lessen in frequency and severity. Followup bloodwork was essential then, as it is now. No more than 1 seizure in a 3-6 month time frame is the ideal goal. Yet, your vet ceased treating with phenobarbitol and did nothing else? Unacceptable!!
Was Perni ever diagnosed with liver shunting, a congenital heart defect or any other developmental anomoly? Did your vet ever persue diagnostics to rule these things out? Was Perni, his mother, or his siblings ever at risk for distemper or aquire distemper? Was nutritional deficiencies or excesses ever ruled out? How often did you have Perni fully evaluated, bloodwork done to monitor liver, kidney, heart function? Have you had yearly exams and full bloodwork/urinalyses done?
Sudden weight loss, vomiting, hypothermia, anorexia, weakness, wobbliness, etc were ALL red flags that your vet needed to persue additional diagnostics to get to the root of the problem, those options are as mentioned above and I wonder if he discussed any of them with you?
If he has renal/liver disease, do NOT use anything with salt in it, including any type of broths. When using phosphate binders and potassium supplements, you MUST followup on bloodwork frequently to ensure it is not in excess and affecting major organ function. If he is lapping at his food rather than chewing, this could be due to painful mouth such as diseased teeth, gingivitis, oral ulcers, or even nausea. Your vet should have discussed an appetite enhancer, something to buffer the stomach to prevent vomiting and nausea. If he isn't taking to the K/D, ask the vet for another veterinary equivalent diet, such as Purina's veterinary diets, etc.
The vet needed to tell you if Perni has chronic renal failure or acute renal failure, and what the liver problem is. There are various liver diseases that need to be addressed and treated specifically. Is there bile sludge? Is there hepatic lipidosis? Is there a cyst on the liver? Is there cholangiohepatitis? Did he discuss any of these with you? Did he perform specific liver testing to rule these out? Did he prescribe antibiotics for secondary bacterial infections?
You truly have to get a handle on giving subcutaneous fluids. Did the vet actually show you how to give them properly? There shouldn't be any time where air is injected, done properly this doesn't happen. It isn't unusual for the actual fluid to produce a large pocket under the skin and it can take hours for the fluid to disperse, but there should never be air under the skin. Judging by your description, if Perni is a relatively small cat, and is already severely underweight, the fluids should be divided into two parts, with 1/2 given over the left shoulder, and the other half given over the right shoulder. This not only evens out distribution of fluids, but is more comfortable for the cat.
When giving fluids, you must keep the line free from air. Hang the fluid bag on a hanger, suspended over you and the cat so that the fluid flows easily through the line. Open the clamp, let the fluid run through until you see it coming through the end of the needle. This prevents air from accumulating in the line. Do not tangle or wrap the line over anything when storing, just let it drape once over the hanger (and be sure to cap the needle or remove it and replace the end with the fluid line cap it comes with). Do NOT refrigerate a fluid bag. Before administering, place the fluid bag under warm running tap water long enough to warm the fluid inside (takes a few minutes, the fluid should be luke-warm, NOT hot). Warm fluids also are more comfortable for the cat.
Again, I strongly advise getting your kitty to a more experienced and more comitted vet. The seizures left untreated are extremely concerning, and now with renal and liver problems, you cannot afford to leave this undiagnosed appropriately and you sure cannot afford to leave this untreated appropriately! Perni deserves a vet who is committed to finding out WHY he has so many symptoms and he deserves the BEST in treatment. Don't give up on him, he's depending on you to get a qualified diagnosis and effective treatment for him. Get copies of ALL Perni's records faxed to a feline-only vet or feline specialist NOW so they can review them. Chances are, they will pick up on one or more things your current vet is obviously not addressing. Do not wait on this, see a new vet RIGHT NOW.
..........Traci
Re: Looking for advice- kidney/liver problems.
Wow. That's much more than I expected in reply. Thank you very much for your care and concern!
The testing you wrote about- full bloodwork, urinalysis, thyroid, immunology, etc.- these things are common sense to me. I was surprised that you mentioned oral exams specifically (not surprised in regards to Perni, but in general) as they're part of my vet's basic exam, no matter why you bring the critter in. And, yes, it's an actual oral exam, not a lick an' a promise.
I understand that you see a lot of folks in here that attempt to diagnose problems on their own before seeing a vet, or try to avoid seeing a vet because they don't understand how serious their cat's condition is or can become. I'm not one of those people. I do know a bit more than the basics of feline care, but I'm not fool enough to try to diagnose or treat, and I do NOT procrastinate about getting them in to the vet.
Our vet is the only vet that I trust with the health and care of my cats. I have known and worked with him for twenty-six years, and he's well-known as THE Vet in our area. He and his colleagues have never failed me, nor have they given me reason to doubt their experience, abilities, or knowledge. Also, he's never hesitated to refer us to another vet that he feels has more experience in the area of concern. As an example, he suggested an excellent specialist/surgeon recently for my older housecat who had recurring ear polyps/infections; after an attempt at treatment without surgery, she's recovering very well from her TECA. She's in my lap, twitching her ears at me, as I type.
When I moved out of this area for four years, I searched for another vet. After fair to horrible experiences with three other vets, I chose to make the forty-five minute drive back to this vet's office instead of subjecting my kids to inferior care. Being closer to his clinic was a large part of my decision to move back here. My cats are my children; they get the best.
I also have a close friend that's a vet; I've consulted her on occasion to verify what my vet has said when I've brought in something rare, or to further investigate another vet that he's suggested. Even the best could make a mistake. I'm as thorough as I can be, which is part of why I came to this message board.
I avoided going into great detail on Perni's test results, or diagnosis, because I wanted to verify that we weren't missing something we should be doing. Sometimes you learn things by not giving all the details. There are a couple of things that you've mentioned that I'll be asking him about- specifically, more focus on the liver. I haven't heard him mention all of that, which most likely means he's ruled those things out, but there's always a chance he hasn't. We have discussed a specialist. If Perni's tests don't continue to show improvement, we'll definitely be going.
I was also hoping to find someone who'd been through something similar with their cat. A little comfort for the human, y'know? I like to know everything I can about whatever is going on, and hearing someone else's experience often helps with that.
My vet communicates with me fully, verbally and in writing. He provides me with copies of all test results with written notes to explain things further, and often suggests other sources of information for me to research (books, websites, so on).
About Perni's seizures-
Again, all previous blood test results have been within normal ranges. Testing to attempt to identify the source/cause of his seizures was done years ago (approx. five years). No cause has ever been found, despite the extensive testing through my vet and a specialist (blood to xray, and everything in between). I also took him to two other highly recommended vets in other cities; neither could find a cause. We've done yearly exams and testing to see if anything changes or pops up, but nothing has.
Ceasing the phenobarbital was *my* decision, after discussion with the vets. It was not making any difference in the severity or frequency of his seizures. It's main effect, no matter the dosage, was that Perni spent three months sitting in the bottom of my kitchen cabinets; no interaction with myself or other cats, leaving only to eat, drink, or use the litterbox. THAT was not acceptable.
Before you say again that my vet has failed my tomkitten, or that I have- yes, I could've continued to pursue a solid diagnosis. If I had unlimited resources, or there were more hours in the day to earn more money, I would have. There's a line between "everything you can do" and "destroying your life and the lives of those you love". Crossing that line would've meant I couldn't afford to keep our home, buy the good stuff for the cats to eat, or simply have time to spend with Perni and the girls. That line is actually why I didn't become a vet myself; knowing when you can't do more, and accepting that, is something I struggled with for many years. Also, cats ate my college money. *grin*
I still won't be going into great detail here regarding today's blood and urine tests. His BUN and creatinine are steadily improving, and we've increased his potassium supplement dosage. His urine was completely normal.
Since Sunday morning, he's eaten almost two cans of KD and has started coming up to us to demand food. He made a four point landing on *my* kidneys at three a.m. last night, then informed me that he was hungry. A few minutes ago, he got annoyed because his food didn't immediately appear, and headed for the dry food bowl. He's up to his ears in a bowl of KD right now.
I stopped adding the broth (it was no-salt added broth, but I know it's saltier than he should have), as he's able to eat it without thinning it now. I'm only adding about half a tablespoon of Iams now; he's adjusting to the KD. Still using tongue more than teeth, but more teeth every time. He's drinking normally, and has begun to use the litterbox for more than urinating. His energy level is much higher than it was, and he's begun grooming himself again. And he's getting a lot feistier about taking his meds!
We went over the subcutaneous fluids again in the clinic today, giving them with the vet's supervision. His instructions match yours. We did receive instruction from him last week. I was extremely nervous about it, as it'd been almost seven years since we'd done it, and it was different equipment. I feel more confident now, tho' I'm never comfortable with needles. If we have trouble again, we can go to the clinic; it's a short trip.
I cannot stress enough that neither I, my family, or the vet are giving up on Perni, nor is his care being compromised in any way. Last week, watching my tomkitten fade right in front of me, it was necessary for me to accept that we *will* lose him, whether it's next week, next month, or ten years from now. That acceptance does not affect the level of care he receives, or the effort that we make to keep him with us. If I didn't let myself feel it and accept it, I'd still be crying- that wouldn't do much for Perni except get his fur wet.
I truly do appreciate the information and time you've given me. It's so reassuring to see that there are people like you that care so much, and are willing to share their knowledge to help others. Thank you!!!!!!!!
-Ori
The testing you wrote about- full bloodwork, urinalysis, thyroid, immunology, etc.- these things are common sense to me. I was surprised that you mentioned oral exams specifically (not surprised in regards to Perni, but in general) as they're part of my vet's basic exam, no matter why you bring the critter in. And, yes, it's an actual oral exam, not a lick an' a promise.
I understand that you see a lot of folks in here that attempt to diagnose problems on their own before seeing a vet, or try to avoid seeing a vet because they don't understand how serious their cat's condition is or can become. I'm not one of those people. I do know a bit more than the basics of feline care, but I'm not fool enough to try to diagnose or treat, and I do NOT procrastinate about getting them in to the vet.
Our vet is the only vet that I trust with the health and care of my cats. I have known and worked with him for twenty-six years, and he's well-known as THE Vet in our area. He and his colleagues have never failed me, nor have they given me reason to doubt their experience, abilities, or knowledge. Also, he's never hesitated to refer us to another vet that he feels has more experience in the area of concern. As an example, he suggested an excellent specialist/surgeon recently for my older housecat who had recurring ear polyps/infections; after an attempt at treatment without surgery, she's recovering very well from her TECA. She's in my lap, twitching her ears at me, as I type.
When I moved out of this area for four years, I searched for another vet. After fair to horrible experiences with three other vets, I chose to make the forty-five minute drive back to this vet's office instead of subjecting my kids to inferior care. Being closer to his clinic was a large part of my decision to move back here. My cats are my children; they get the best.
I also have a close friend that's a vet; I've consulted her on occasion to verify what my vet has said when I've brought in something rare, or to further investigate another vet that he's suggested. Even the best could make a mistake. I'm as thorough as I can be, which is part of why I came to this message board.
I avoided going into great detail on Perni's test results, or diagnosis, because I wanted to verify that we weren't missing something we should be doing. Sometimes you learn things by not giving all the details. There are a couple of things that you've mentioned that I'll be asking him about- specifically, more focus on the liver. I haven't heard him mention all of that, which most likely means he's ruled those things out, but there's always a chance he hasn't. We have discussed a specialist. If Perni's tests don't continue to show improvement, we'll definitely be going.
I was also hoping to find someone who'd been through something similar with their cat. A little comfort for the human, y'know? I like to know everything I can about whatever is going on, and hearing someone else's experience often helps with that.
My vet communicates with me fully, verbally and in writing. He provides me with copies of all test results with written notes to explain things further, and often suggests other sources of information for me to research (books, websites, so on).
About Perni's seizures-
Again, all previous blood test results have been within normal ranges. Testing to attempt to identify the source/cause of his seizures was done years ago (approx. five years). No cause has ever been found, despite the extensive testing through my vet and a specialist (blood to xray, and everything in between). I also took him to two other highly recommended vets in other cities; neither could find a cause. We've done yearly exams and testing to see if anything changes or pops up, but nothing has.
Ceasing the phenobarbital was *my* decision, after discussion with the vets. It was not making any difference in the severity or frequency of his seizures. It's main effect, no matter the dosage, was that Perni spent three months sitting in the bottom of my kitchen cabinets; no interaction with myself or other cats, leaving only to eat, drink, or use the litterbox. THAT was not acceptable.
Before you say again that my vet has failed my tomkitten, or that I have- yes, I could've continued to pursue a solid diagnosis. If I had unlimited resources, or there were more hours in the day to earn more money, I would have. There's a line between "everything you can do" and "destroying your life and the lives of those you love". Crossing that line would've meant I couldn't afford to keep our home, buy the good stuff for the cats to eat, or simply have time to spend with Perni and the girls. That line is actually why I didn't become a vet myself; knowing when you can't do more, and accepting that, is something I struggled with for many years. Also, cats ate my college money. *grin*
I still won't be going into great detail here regarding today's blood and urine tests. His BUN and creatinine are steadily improving, and we've increased his potassium supplement dosage. His urine was completely normal.
Since Sunday morning, he's eaten almost two cans of KD and has started coming up to us to demand food. He made a four point landing on *my* kidneys at three a.m. last night, then informed me that he was hungry. A few minutes ago, he got annoyed because his food didn't immediately appear, and headed for the dry food bowl. He's up to his ears in a bowl of KD right now.
I stopped adding the broth (it was no-salt added broth, but I know it's saltier than he should have), as he's able to eat it without thinning it now. I'm only adding about half a tablespoon of Iams now; he's adjusting to the KD. Still using tongue more than teeth, but more teeth every time. He's drinking normally, and has begun to use the litterbox for more than urinating. His energy level is much higher than it was, and he's begun grooming himself again. And he's getting a lot feistier about taking his meds!
We went over the subcutaneous fluids again in the clinic today, giving them with the vet's supervision. His instructions match yours. We did receive instruction from him last week. I was extremely nervous about it, as it'd been almost seven years since we'd done it, and it was different equipment. I feel more confident now, tho' I'm never comfortable with needles. If we have trouble again, we can go to the clinic; it's a short trip.
I cannot stress enough that neither I, my family, or the vet are giving up on Perni, nor is his care being compromised in any way. Last week, watching my tomkitten fade right in front of me, it was necessary for me to accept that we *will* lose him, whether it's next week, next month, or ten years from now. That acceptance does not affect the level of care he receives, or the effort that we make to keep him with us. If I didn't let myself feel it and accept it, I'd still be crying- that wouldn't do much for Perni except get his fur wet.
I truly do appreciate the information and time you've given me. It's so reassuring to see that there are people like you that care so much, and are willing to share their knowledge to help others. Thank you!!!!!!!!
-Ori
-
mamabear
- Formerly mamaof4soon
- Posts: 589
- Joined: Wed Apr 18, 2007 10:39 pm
- Location: The Garden State
Re: Looking for advice- kidney/liver problems.
I can not give you any more information than Traci has provided or that you don't already know through your own researching. I CAN say that we're here for you to vent or ask or even be happy at something good happening for him. My last two cats were a long time ago. Whispers had liver/kidney disease and very much advanced and was put down. Had he been diagnosed sooner we might have been able to give him a better chance. My other cat Tiger, she was put down due to complications with Hyperthyrodism..Something that I have as well now. (weird huh lol)
I commend you for asking and checking and rechecking on things and giving him the best care you feel he needs. Keep up the good work!!!!!
((((ori))))
Oh yeah and when people that are non cat folk say that you are nuts tell them to buy a cat and then talk!
lol
Keep us posted please.
I commend you for asking and checking and rechecking on things and giving him the best care you feel he needs. Keep up the good work!!!!!
((((ori))))
Oh yeah and when people that are non cat folk say that you are nuts tell them to buy a cat and then talk!
lolKeep us posted please.
Almost 7 years in remission from Graves disease and no meds!
Re: Looking for advice- kidney/liver problems.
I'm confused. You asked for advice and things you should be checking and asking your vet, yet will not provide the information that would allow us to help further. Having needed information up front is more helpful than you realize, and allows us to give you information quickly, thereby limiting wasted time.
You sing the praises of your vet, yet, you specifically asked for informaiton/experience...when given, it doesn't sound like you're willing to accept that your vet in fact may not be as experienced or knowledgeable as you surmise.
I completely and totally disagree about the prior seizure treatment Perni recieved. Assuming your vet was fully aware that YOU stopped giving the phenobarbitol, then it was incumbent upon him to discuss the risks of NOT treating seizure activity. There are three major problems here:
1) If your vet did NOT thoroughly discuss the risks with you about NOT treating seizure activity, then he IS incompetent.
2) If your vet DID discuss with you those risks, yet did not offer other diagnostics to persue the cause, and simply told you it was perfectly acceptable NOT to treat the seizures, then he IS incompetent.
3) If your vet discussed with you the risks, and offered additional diagnostics, or warned you of the seriousness of not treating seizures, and you declined additional diagnostics or did not heed his advice, then he is not liable, you are.
4) You didn't provide any information about the length of phenobarbitol treatment, the doseage, and whether or not it was discussed with your vet to adjust the dose as necessary, with necessary followup bloodwork for pheno levels. Simply deciding to stop the phenobarbitol on your own accord because it was affecting behavior doesn't fully justify the cessation of phenobarbitol. As explained earlier, adjustments in doseage are necessary in the beginning of the course of treatment, and it can take time and patience to determine acceptable levels, appropriate doseage.
5) You noted there is frequency and longer recovery periods during any seizure event. If your vet isn't telling you just how serious that is, or if you aren't telling your vet about every seizure event Perni has had and continues to have, then neither of you are doing what's "best" for Perni. As explained earlier, the more frequent the seizures, the longer the recovery period, the MORE SERIOUS each siezure will become until it leaves Perni totally incapacitated and at extreme risk for organ failure, CNS destruction, even coma and death (organ damage or CNS deficits could already be occuring as a result of siezures not being treated appropriately). Treating seizure activity to PREVENT additional seizures is paramount. Perni should have been given the opportunity, no matter how long it took, to have had treatment to both DETERMINE the medication's effect on preventing seizures, and to expect seizure events to be LIMITED.
You have to understand how serious seizures are. They can totally debilitate the patient, and can damage vital organ function and the entire system. Without treatment, most often they will never subside, nor will they ever lessen in severity, nor will they ever lessen in frequency. In fact, they will often increase in frequency, cause more damage, and there is ALWAYS the risk of a seizure so severe it will cause coma and/or death.
As explained earlier, regardless if the siezures are of unknown origin, they must be treated. Perni is a perfect example of bad seizure activity left untreated where it is only progressing and is affecting his health badly.
Now he has renal failure and some "undiagnosed" liver problem. Are you and your vet surprised? Perni is only six years old, he shouldn't be in this shape at all, and I truly believe more should have been done earlier to prevent this. Despite your relationship with your vet for 26 years, know that it doesn't matter how long he has been in practice, that alone does not make him perfect. Is there a more qualifed vet available? Chances are, 100% yes, and once again, it sounds like Perni needs a feline specialist to diagnose him properly and to initiate effective treatment. He deserves better, and if he has the chance to be diagnosed more specifically, and get effective treatment, then isn't that what matters most? Unfortunately, it could be that the untreated seizures brought him to this state, but there is every chance that the kidney and liver problems could still be treated effectively. There is still the need of getting him started on seizure treatment as well, and I strongly advise you to get Perni to a feline specialist IMMEDIATELY for proper treatment. That's what your vet should have done years ago.
You sing the praises of your vet, yet, you specifically asked for informaiton/experience...when given, it doesn't sound like you're willing to accept that your vet in fact may not be as experienced or knowledgeable as you surmise.
You said that in your first post as well, and it has me concerned because in reading your entire two posts, despite your omission of information, it does not in fact sound like your vet has been doing enough for Perni, and unless you want to provide the information requested, then at this point, that's all I can assume. There's many things in your posts that leave me wondering if all of them should have been addressed more appropriately YEARS ago.Ori wrote:Last week, watching my tomkitten fade right in front of me, it was necessary for me to accept that we *will* lose him, whether it's next week, next month, or ten years from now. That acceptance does not affect the level of care he receives, or the effort that we make to keep him with us. If I didn't let myself feel it and accept it, I'd still be crying- that wouldn't do much for Perni except get his fur wet.
I completely and totally disagree about the prior seizure treatment Perni recieved. Assuming your vet was fully aware that YOU stopped giving the phenobarbitol, then it was incumbent upon him to discuss the risks of NOT treating seizure activity. There are three major problems here:
1) If your vet did NOT thoroughly discuss the risks with you about NOT treating seizure activity, then he IS incompetent.
2) If your vet DID discuss with you those risks, yet did not offer other diagnostics to persue the cause, and simply told you it was perfectly acceptable NOT to treat the seizures, then he IS incompetent.
3) If your vet discussed with you the risks, and offered additional diagnostics, or warned you of the seriousness of not treating seizures, and you declined additional diagnostics or did not heed his advice, then he is not liable, you are.
4) You didn't provide any information about the length of phenobarbitol treatment, the doseage, and whether or not it was discussed with your vet to adjust the dose as necessary, with necessary followup bloodwork for pheno levels. Simply deciding to stop the phenobarbitol on your own accord because it was affecting behavior doesn't fully justify the cessation of phenobarbitol. As explained earlier, adjustments in doseage are necessary in the beginning of the course of treatment, and it can take time and patience to determine acceptable levels, appropriate doseage.
5) You noted there is frequency and longer recovery periods during any seizure event. If your vet isn't telling you just how serious that is, or if you aren't telling your vet about every seizure event Perni has had and continues to have, then neither of you are doing what's "best" for Perni. As explained earlier, the more frequent the seizures, the longer the recovery period, the MORE SERIOUS each siezure will become until it leaves Perni totally incapacitated and at extreme risk for organ failure, CNS destruction, even coma and death (organ damage or CNS deficits could already be occuring as a result of siezures not being treated appropriately). Treating seizure activity to PREVENT additional seizures is paramount. Perni should have been given the opportunity, no matter how long it took, to have had treatment to both DETERMINE the medication's effect on preventing seizures, and to expect seizure events to be LIMITED.
You have to understand how serious seizures are. They can totally debilitate the patient, and can damage vital organ function and the entire system. Without treatment, most often they will never subside, nor will they ever lessen in severity, nor will they ever lessen in frequency. In fact, they will often increase in frequency, cause more damage, and there is ALWAYS the risk of a seizure so severe it will cause coma and/or death.
As explained earlier, regardless if the siezures are of unknown origin, they must be treated. Perni is a perfect example of bad seizure activity left untreated where it is only progressing and is affecting his health badly.
Now he has renal failure and some "undiagnosed" liver problem. Are you and your vet surprised? Perni is only six years old, he shouldn't be in this shape at all, and I truly believe more should have been done earlier to prevent this. Despite your relationship with your vet for 26 years, know that it doesn't matter how long he has been in practice, that alone does not make him perfect. Is there a more qualifed vet available? Chances are, 100% yes, and once again, it sounds like Perni needs a feline specialist to diagnose him properly and to initiate effective treatment. He deserves better, and if he has the chance to be diagnosed more specifically, and get effective treatment, then isn't that what matters most? Unfortunately, it could be that the untreated seizures brought him to this state, but there is every chance that the kidney and liver problems could still be treated effectively. There is still the need of getting him started on seizure treatment as well, and I strongly advise you to get Perni to a feline specialist IMMEDIATELY for proper treatment. That's what your vet should have done years ago.
..........Traci
-
mamabear
- Formerly mamaof4soon
- Posts: 589
- Joined: Wed Apr 18, 2007 10:39 pm
- Location: The Garden State
Re: Looking for advice- kidney/liver problems.
Totally confused here. He was on meds that you stopped? You have no idea if they were working except from what you 'saw' on the outside. YOu dont know what it was doing on the inside or to his brain. It might be helping him. I'd have to say for someone who says they know this area you seem to not be paying to too much attention because this cat is ONLY 6 and very young and no need for this to be happening to him. Who cares how long you have known your vet ? If things are being done halfassed then a new vet you should find. You do not seem to want to leave your vet so therefore the treatment of care wont change and I am not sure you are willing to go to another vet to get the right treatment.
If you are not willing to change the vet or what you are currently doing, then I am not understanding what you are asking of us. He is young and you saying you understand he will just die is something i cant figure out. Get him to a vet that will figure out the right diagnosis and get it treated to the best of your ability. Why would you even think to settle for less?
Hope all works out. Prayers for kitty for something to be done on his behalf soon.
If you are not willing to change the vet or what you are currently doing, then I am not understanding what you are asking of us. He is young and you saying you understand he will just die is something i cant figure out. Get him to a vet that will figure out the right diagnosis and get it treated to the best of your ability. Why would you even think to settle for less?
Hope all works out. Prayers for kitty for something to be done on his behalf soon.
Almost 7 years in remission from Graves disease and no meds!