9/30 Alice - PMPS 307 +2.15 268 +6 246 +8.3 230 +11 205 | Vet. Kidney failure.

AliceMeowliss (GA)

AliceMeowliss (GA)

Member Since 2019
https://www.felinediabetes.com/FDMB...ic-pmps-370-4-5-295-9-69.236121/#post-2646609

For now I’m just going to post her bloodwork. I’m waiting to get her in the car and take her home and work on a plan for the next few days.

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My baby.
 

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It has been suggested I still get her urine C&S and see if the infection can be resolved and if that will allow for improvement.

I don’t know what to do.



in the meantime vet visit messed with her shot time which was already at a late and annoying time, so I guess for the moment we are just... sitting.... I’ll restart her shot time at a nice healthy early evening time. It’ll end up being +19 or so...



she took 300mL at the vet, I asked the tech to give me a break for the day! Alice finished off that bag. We got a new one to last us a few days.

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now she is making biscuits on my belly. She’s so close to death but still... not ready to die. I swear it doesn’t feel right.
 

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Her kidneys are just so bad I don’t know that much is recoverable at this point. So should we get the culture and try to fight and remaining infection and stay the course or should we admit defeat?

There’s always possibility she could have some underlying cancer again, too.

She could also consult with IM but again, is it worth the expense when those funds could help others in need? Alice is worth the world to me however I still care to be practical and not to be wasteful especially at a home else’s expense. Plus her suffering and all.
 
Bellasmom said:
Sorry to read this Cassandra, I say go with what u think is best for Alice, to make her as comfortable as u can I would give her fluids. 100ml 2x a day as suggested by vet.
We can only give suggestions ultimately u have to decide what u think is best for her
:bighug::bighug::bighug::bighug::bighug::bighug:
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Definitely trying to help her be comfortable. She took 300mL today at the vet. I’ll be making sure she gets more because I see now very clearly what a difference it makes.


Someone on the CKD group said “Without the culture they do not know what antibiotic will kill the specific bacteria. It's very possible that the two antibiotics they gave were not right and her infection is just getting worse. She needs a culture and possibly IV antibiotics and fluids, along with something such as Niacinamide to bring the phosphorus down quickly.”

So I am giving serious thought to checking the 24/7 hospital in the city that I’ve had recommended. They should have an IM vet on staff, they can simply ultrasound her bladder and get urine for C&S without waiting all day for it to just be full like my regular vet would have to do. They could give her an IV if warranted and flush some stuff out and that would be amazing. She would feel so much better. Then she could be more comfortable while we figure out if the infection is solvable....




Thank you everyone for your kind words, information, and support. I cried my eyes out on the way home from the vet. Called my mom to cry, and let my heart break a little more. Now I’m just very very worn out physically and emotionally. I’ve barely eaten for a couple days and hardly slept all month. Tonight I’ll practice some self-care. I know I have to lose her one of these days but she is my child and I have to do right by her before I throw in the towel. But I have never had to make this decision, and of all people in the world, having to make the decision for her......
She was tiny. Newborn. My baby. I gave her bottles. I rescued her. And in my fantasy world she and I should get to grow old together.

I just know one of these days I’m really going to miss giving shots and checking blood sugar. :(

Sorry for all the emotional dumping. Thanks everyone.
 
Tom & Thomas (GA) said:
Oh, Cassandra... I hope Alice's brave little spirit continues to keep her with you.
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her bio mom was a semi-feral cat. We saved that cat and brought her back from the brink of death numerous times. Bio-mama had an abscess two days after Alice and siblings were born and almost died from that too. But I insisted the vet wait to euthanize, and she pulled through again!
I keep hoping it’s genetic and Alice really does have nine lives.

Thanks for stopping by. TomTom the bunny says hi. :)
 
A few notes for the day since I guess her journey is not just yet over...

she had a bowel movement that wasn’t diarrhea! She sat on it and it stuck to her bum but I’ll take it for what it’s worth. :p It was a good dark color and soft ish but solid and formed. Small.

weighed earlier and she was up to 2.57kg, this is with the 300mL fluids she has gotten today.

Dinner syringed about 15mL of leftovers
+3.5 we syringed a newly blended can, about 21mL because she was taking it really well

She is so weak but she is still going to the litter box, climbing into her “I’m laying alone now” basket, and still wants to get up on the bed to cuddle a lot. She can dismount from the bed but she stumbles her landing. I have mats and rugs and blankets all around the floor in our room just in case she needs a soft landing. She is also willing to ask for affection from the other household human. She was interested in the freshly opened can of ziwi and licked it some but she still won’t bite or chew food and I couldn’t get her to lap it up this time. Sometimes she will lap up a little but it’s not at all enough.

Anyway, these are all little positives. And seriously, I love what the subq fluids do. I wish I hadn’t spent the previous week so heavily medicated so I could have given fluids more then. If there is a next time I will go lighter on the pain meds so I can be there for her better.
 
@carfurby Carla, I didn’t get the fancy art pieces in yet so I set Alice up with this, a family photography studio with litter box viewing. Very upscale, all the rage with the kitty teenagers these days.

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(Re: the cute link with the picture of the kitty with the art gallery by the litter box :D )
 

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I'm sorry Cassandra, I know this is so hard. A couple of things that jumped out from your bloodwork. Phosphorus is way too high, if you choose to continue to treat Alice, you need to get that in check immediately with phosphorus binders in her food, it is likely contributing substantially to her feeling unwell. Please do consult with your vet, but this is a good reference on phosphorus binders, and when they are needed, I know it is a lot of reading, but this website in general holds a lot of important info relating to kidney disease...http://felinecrf.org/phosphorus_binders.htm

Also of concern is her low potassium value, which is also something that needs to be managed via supplements, you want her firmly above 4. http://felinecrf.org/potassium.htm

Her weakness is a classic symptom of low potassium.
But, you need to monitor regularly via blood work with vet if you give supplements, since too high is even more problematic, with serious health complications.

Sending lots of healing vines, and prayers :bighug:
 
Christie & Maverick said:
I'm sorry Cassandra, I know this is so hard. A couple of things that jumped out from your bloodwork. Phosphorus is way too high, if you choose to continue to treat Alice, you need to get that in check immediately with phosphorus binders in her food, it is likely contributing substantially to her feeling unwell. Please do consult with your vet, but this is a good reference on phosphorus binders, and when they are needed, I know it is a lot of reading, but this website in general holds a lot of important info relating to kidney disease...http://felinecrf.org/phosphorus_binders.htm

Also of concern is her low potassium value, which is also something that needs to be managed via supplements, you want her firmly above 4. http://felinecrf.org/potassium.htm

Her weakness is a classic symptom of low potassium.
But, you need to monitor regularly via blood work with vet if you give supplements, since too high is even more problematic, with serious health complications.

Sending lots of healing vines, and prayers :bighug:
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Thank you. We are aware of these things specifically.
She has been receiving potassium supplementation intermittently since March. She had an episode of hypokalemia due to inappetence from constipation then. No CKD dx back then. She had bloodwork 8/31 and that’s when she got the kidney dx.
She is getting aluminum hydroxide for her phosphorous binder, we started the month with the Maalox our vet gave us and switched to the ALOH when we got in the mail. She has been on a dose that should be 1/2tsp a day total but since she hasn’t eaten much I hadn’t figured out yet if I just give the same amount even if she barely eats.

I’m sort of interested in looking into niacinamide, do you have any experience with this?
 
Apologies, I haven't really been here so I didn't know of the history. I do not have any experience with niacinamide, my experience is quite old with CRF, I had two cats, one with late stage diagnosis, over 10 years ago. At that time, I treated both with Epakitin, which isn't as popular now.

It appears from a quick search that niacinimide should be used cautiously with diabetic cats.
 
Christie & Maverick said:
Apologies, I haven't really been here so I didn't know of the history. I do not have any experience with niacinamide, my experience is quite old with CRF, I had two cats, one with late stage diagnosis, over 10 years ago. At that time, I treated both with Epakitin, which isn't as popular now.

It appears from a quick search that niacinimide should be used cautiously with diabetic cats.
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Thanks. What is the particular risk to diabetic cats? I would love it if she could have a faster way to flush some of the phosphorous out. Just so she could feel a little better for awhile. :\

Sigh. I wish Alice’s had been diagnosed earlier. This dx right when she is on the precipice of stage 4 and I didn’t know much about kidney disease in cats yet... Along the way through her journey of illnesses there have been a lot of “if we caught this sooner” and “if I knew then what to do...”
But we can’t change the past, only move forward.

Thanks for stopping in with your input. :) I am always grateful.
 
Christie & Maverick said:
Sometimes you do everything right, but things still go wrong :bighug:. Might be worth asking your vet, but I suspect it might increase blood glucose levels, not entirely sure though, see here from VCA hospitals https://vcahospitals.com/know-your-pet/niacinamide

I would think if it helps get the phosphorus down, and if indeed it affects BG you can always adjust the insulin to compensate.
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I agree. I am absolutely at the point where first of all, OTJ isn’t going to happen. Would’ve been cool, but it’s never happening. Infections etc etc. She wouldn’t stay off it for long if she did go OTJ.

At this point I would even feed a higher carb wet food if it were easier on her kidneys, and just give more insulin.
Back when she was recovering from DKA we sometimes kind of did the “feed the curve” thing and I would prop her with mid carb a lot and let the insulin balance things out. I have wondered if there could be a recipe for IBD kidney diabetic homemade food that had higher carbs but that one could compensate for with insulin..... don’t the kidney foods usually have higher carbs, or higher fats, to reduce the protein percentage?
 
Syringed 15mL food, 3mL water, and phos binder. She’s looking decent actually. Fur and eyes are pretty bright. She’s in her basket for alone time right now, but I know when I go to lay down for my big 4 hour nap for the night that she will be up cuddling me in bed.

I am so sleepy but have been so afraid to sleep, many moments this month. I glance over to check to see if her chest is rising and falling, see if she is breathing. A lot. Tonight though her sugar is flat yellows and she has had a few feedings and she had 300mL fluids today so I think I can afford a rest.

Her next shot will be a +14 or so as I get her adjusted back to a time I can tolerate.
 
Simon had a UTI and it didn’t resolve after the first course of antibiotics- so my vet finally did a culture with a sensitivity analysis and sure enough once we had the right drug he felt better right away! I really hope the same thing happens for Alice! Best of luck to you :bighug:
 
Kyle & Simon said:
Simon had a UTI and it didn’t resolve after the first course of antibiotics- so my vet finally did a culture with a sensitivity analysis and sure enough once we had the right drug he felt better right away! I really hope the same thing happens for Alice! Best of luck to you :bighug:
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It would sure be a start to her feeling any better!! I hope I can find someone in the morning that will see her and that she has enough pee. Haha. :) Thanks for your supportive words.
 
So, something I want to note, her blood has been really watery lately when I poke her for testing. I don’t know what it means. It’s just different. It seems thinner. Maybe not important.

Anyway after all is done, she had had roughly 75 calories this cycle. That’s enough for maybe 3 lbs body weight? But she isn’t interested in having more food syringed (I have pushed some, I can only push so far!) and if I want any sleep it has to happen ASAP. If I shoot at +14 and bring her around to a 6/6 time then I have 4.5 hours now to rest.

I hope tomorrow I find a vet for her urine culture. I hope that it isn’t too difficult to get her fluids into her next round. I hope she gets some help to feel a little better and be more comfortable.

Today was difficult and long. I wonder what our tomorrow will hold.
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The Alone Basket
 

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