C.W. Gortner
Member Since 2016
Hi all,
I've posted here before and people have been so kind, I'm hoping for help. My beloved ex-feral Mommy went into crisis and was hospitalized in December of last year, which is when we discovered her diabetes. At the time, her vet said her outlook was very uncertain; she had severe pancreatitis, but we persisted and she pulled through. Her blood work at the time also indicated stage 1 CKD, with a high "normal" creatinine. With 1 unit of Lantus twice daily, we got her diabetes under near-perfect control. She went asymptomatic and has been fine for these past eight months.
Last Monday, we woke up to find her drooling and lethargic, clearly in distress; I suspected a tooth infection and rushed her to emergency at the veterinary practice. It was indeed a tooth infection, but her blood work also showed her creatinine value had leaped to 7.6. My vet, who is part of this very expensive specialty practice, expressed panic at the renal values and wanted her hospitalized immediately for IV fluids, until I refused and offered to do sub-q fluids at home. With her insulin, Mommy needs to eat and she wouldn't when she was hospitalized before; we had to visit her twice a day and sing to her, getting her to eat a little, but never enough. Instead, we did sub-q at home, plus a week of Clavamox and Buprenex for pain. The antibiotics and pain med took their toll - she became quite nauseous and sedated by day 5 - but we gave her some Cerenia, which helped a bit. On Sunday, within 24 hours of ending pain med and antibiotics, she was eating again. On Monday, she ate her full three meals and seemed like her sweet self again.
We had a follow-up today to re-check her kidney values and schedule her dental, which she needs. I'd thought her elevated renal numbers - they've just shot so high in eight months - was due to her untreated tooth infection, so I was certain the values would be lower, if not yet back to her Dec '17 level. Instead, her creatinine came in at 8.9 and her BUN was 140. Higher than Monday. Stage IV kidney disease, said the vet. She was gentle but grim; she told me it was likely "a matter of weeks" before we'd have to let Mommy go.
Of course, I started to cry, as I know these numbers look dire. Paradoxically, Mommy's BG came in so low - it measured 32 at the vet - they told me to discontinue insulin for at least two weeks. She was eating until this vet visit today; we were at that practice for two solid hours, because they always run late, and the dental consult, which we had immediately after the follow-up, was interrupted by my vet with the in-house kidney panel they'd run. It was then, as the dentist slipped out, that my vet delivered the dire news.
Once we got home, Mommy went under the bed and refused to come out. She's exhausted and very stressed out, so I let her rest. In the evening, we had to do sub-q fluids again - the vet now wants it daily - so I had to get her out. She showed immediate interest in food, but after nibbling a bite or so, she made a strange movement, as if she was either in pain or nauseous, lowering her head and staying very still as I soothed her. She tried again to eat a bit later, but took another bite and stopped. I couldn't tell if it was nausea or pain, but I gave her Cerenia and the sub-q fluids. She's now very lethargic. She went back under the bed and has remained there all night. She's not eating at the moment, which is a very abrupt switch from this morning, when she gobbled down her breakfast and asked for more. She was purring and resting in her usual spot. Two hours at the vet and she's a completely different cat.
To complicate matters, I've been reading up as much as I can on chronic kidney disease (CKD) and she's not showing any of the classic symptoms of stage IV, except in her blood work. She did have significant nausea on Clavamox, but her appetite returned. Her BG hitting so low freaked me out, too, but the vet said this is common; as kidney function deteriorates, insulin requirements shift. I'll home-test her BG as best as I can during these next two weeks. She doesn't mind sub-q fluids or insulin shots, but BG home testing - mainly, pricking her ear - was never her cup of tea, and she'll evade / hide much more if I do it too often. Her entire temperament reverts to feral. She's very sweet and docile as a rule, but we simply haven't been able to get her fully comfortable or adjusted to daily BG home testing. Go, figure. That said, her BG has been relatively stable on spot checks, and she's had no diabetic symptoms once we figured out her Lantus dose.
Today, my vet basically offered no alternatives except daily sub-q, Cerenia as needed, and to "watch and wait." She was very gentle, as I said, but convinced nothing more could be done, even though this dental issue could very well still be an issue. When she mentioned euthanasia, I kept repeating that Mommy's diabetes is under control. She was fine, happy. Eating. She had this awful tooth flare-up and suddenly, her kidney values skyrocket. I know CKD is incurable and progressive, but how can she go from stage 1 to stage IV in eight months? Something in my gut keeps telling me it's her dental issues, but maybe that's my denial. She is a senior; I'm not sure of her exact age, but no more than 13 at most, so this has all hit me like a falling brick wall.
I'm not sure if being CKD asymptomatic at her extreme renal values is even likely, either. The vet did admit the entire practice was in awe of Mommy; according to them, most cats at these high values will display unkempt coats, frequent and out-of-the-box urination, little to no appetite and significant ongoing nausea. Mommy has shown none of these, except nausea and no appetite, which coincided with her tooth infection, and both resolved after treatment. The vet now refuses to even consider a dental, saying putting her under anesthesia will kill her.
I don't want to go to heroic measures, as I realize CKD will eventually win, but I do want to do as much as I can for Mommy. We love her so much. Any advice is welcome. I have so many questions. Could her values eventually decline on daily sub-q fluids? Was taking her values only a week after an infection too little time? Was a week of Clavamox enough for a tooth infection and/or might she need a different antibiotic for more time? The vet kept saying, no, that as her values have gone up, not down, that's it. She's on her way out. And we need to stop insulin. To the vet, it's hopeless.
I tend to always look at things more holistically, but I'm near-despair. I'm hoping her current hibernation is stress-related and in the next day or so, she'll start eating again. I also have her labs, in case anyone wants a particular value. I know we're not vets here, but we know our cats. Often better than the vet.
https://docs.google.com/spreadsheets/d/1sRDafKbj3GwqINulhVUrzIAuMkKzZjFvdfQUJZCOxy4/edit?usp=sharing
I've posted here before and people have been so kind, I'm hoping for help. My beloved ex-feral Mommy went into crisis and was hospitalized in December of last year, which is when we discovered her diabetes. At the time, her vet said her outlook was very uncertain; she had severe pancreatitis, but we persisted and she pulled through. Her blood work at the time also indicated stage 1 CKD, with a high "normal" creatinine. With 1 unit of Lantus twice daily, we got her diabetes under near-perfect control. She went asymptomatic and has been fine for these past eight months.
Last Monday, we woke up to find her drooling and lethargic, clearly in distress; I suspected a tooth infection and rushed her to emergency at the veterinary practice. It was indeed a tooth infection, but her blood work also showed her creatinine value had leaped to 7.6. My vet, who is part of this very expensive specialty practice, expressed panic at the renal values and wanted her hospitalized immediately for IV fluids, until I refused and offered to do sub-q fluids at home. With her insulin, Mommy needs to eat and she wouldn't when she was hospitalized before; we had to visit her twice a day and sing to her, getting her to eat a little, but never enough. Instead, we did sub-q at home, plus a week of Clavamox and Buprenex for pain. The antibiotics and pain med took their toll - she became quite nauseous and sedated by day 5 - but we gave her some Cerenia, which helped a bit. On Sunday, within 24 hours of ending pain med and antibiotics, she was eating again. On Monday, she ate her full three meals and seemed like her sweet self again.
We had a follow-up today to re-check her kidney values and schedule her dental, which she needs. I'd thought her elevated renal numbers - they've just shot so high in eight months - was due to her untreated tooth infection, so I was certain the values would be lower, if not yet back to her Dec '17 level. Instead, her creatinine came in at 8.9 and her BUN was 140. Higher than Monday. Stage IV kidney disease, said the vet. She was gentle but grim; she told me it was likely "a matter of weeks" before we'd have to let Mommy go.
Of course, I started to cry, as I know these numbers look dire. Paradoxically, Mommy's BG came in so low - it measured 32 at the vet - they told me to discontinue insulin for at least two weeks. She was eating until this vet visit today; we were at that practice for two solid hours, because they always run late, and the dental consult, which we had immediately after the follow-up, was interrupted by my vet with the in-house kidney panel they'd run. It was then, as the dentist slipped out, that my vet delivered the dire news.
Once we got home, Mommy went under the bed and refused to come out. She's exhausted and very stressed out, so I let her rest. In the evening, we had to do sub-q fluids again - the vet now wants it daily - so I had to get her out. She showed immediate interest in food, but after nibbling a bite or so, she made a strange movement, as if she was either in pain or nauseous, lowering her head and staying very still as I soothed her. She tried again to eat a bit later, but took another bite and stopped. I couldn't tell if it was nausea or pain, but I gave her Cerenia and the sub-q fluids. She's now very lethargic. She went back under the bed and has remained there all night. She's not eating at the moment, which is a very abrupt switch from this morning, when she gobbled down her breakfast and asked for more. She was purring and resting in her usual spot. Two hours at the vet and she's a completely different cat.
To complicate matters, I've been reading up as much as I can on chronic kidney disease (CKD) and she's not showing any of the classic symptoms of stage IV, except in her blood work. She did have significant nausea on Clavamox, but her appetite returned. Her BG hitting so low freaked me out, too, but the vet said this is common; as kidney function deteriorates, insulin requirements shift. I'll home-test her BG as best as I can during these next two weeks. She doesn't mind sub-q fluids or insulin shots, but BG home testing - mainly, pricking her ear - was never her cup of tea, and she'll evade / hide much more if I do it too often. Her entire temperament reverts to feral. She's very sweet and docile as a rule, but we simply haven't been able to get her fully comfortable or adjusted to daily BG home testing. Go, figure. That said, her BG has been relatively stable on spot checks, and she's had no diabetic symptoms once we figured out her Lantus dose.
Today, my vet basically offered no alternatives except daily sub-q, Cerenia as needed, and to "watch and wait." She was very gentle, as I said, but convinced nothing more could be done, even though this dental issue could very well still be an issue. When she mentioned euthanasia, I kept repeating that Mommy's diabetes is under control. She was fine, happy. Eating. She had this awful tooth flare-up and suddenly, her kidney values skyrocket. I know CKD is incurable and progressive, but how can she go from stage 1 to stage IV in eight months? Something in my gut keeps telling me it's her dental issues, but maybe that's my denial. She is a senior; I'm not sure of her exact age, but no more than 13 at most, so this has all hit me like a falling brick wall.
I'm not sure if being CKD asymptomatic at her extreme renal values is even likely, either. The vet did admit the entire practice was in awe of Mommy; according to them, most cats at these high values will display unkempt coats, frequent and out-of-the-box urination, little to no appetite and significant ongoing nausea. Mommy has shown none of these, except nausea and no appetite, which coincided with her tooth infection, and both resolved after treatment. The vet now refuses to even consider a dental, saying putting her under anesthesia will kill her.
I don't want to go to heroic measures, as I realize CKD will eventually win, but I do want to do as much as I can for Mommy. We love her so much. Any advice is welcome. I have so many questions. Could her values eventually decline on daily sub-q fluids? Was taking her values only a week after an infection too little time? Was a week of Clavamox enough for a tooth infection and/or might she need a different antibiotic for more time? The vet kept saying, no, that as her values have gone up, not down, that's it. She's on her way out. And we need to stop insulin. To the vet, it's hopeless.
I tend to always look at things more holistically, but I'm near-despair. I'm hoping her current hibernation is stress-related and in the next day or so, she'll start eating again. I also have her labs, in case anyone wants a particular value. I know we're not vets here, but we know our cats. Often better than the vet.
https://docs.google.com/spreadsheets/d/1sRDafKbj3GwqINulhVUrzIAuMkKzZjFvdfQUJZCOxy4/edit?usp=sharing
