Jumping back into the fray ...
I have been a bit wrapped up in Nightmare's health issues as of late. He has CRF … which is Chronic Renal Failure. What this means is, his kidney's are no longer working very well. Right now they still work, but they no longer filter out all the toxins from his blood as healthy kidneys would. At some point they won't work at all - but I am trying not to think of that day. This all began just 2 days before Xmas. Nothing says fun like taking an already stressful time of the year, and moving it up a notch 'eh?
One day he was fine, eating and being his normal self. The next day he didn't get up with me, and he was not real interested in food. A couple of vet visits later, and he was admitted to a 24 hour animal hospital for IV fluids. The vet there told me upon admitting him that given the unbelievable levels on his blood test, if he had been a dog he would have been dead. But, he is not a dog and like cats everywhere he had other ideas. After numerous test, which included an ultrasound, they found he had bladder stones, and possibly a blockage may have caused the entire fiasco. After a week in the hospital I took him home and followed up with his regular vet. She really wasn't doing anything, and his blood levels were going up again - she only suggested I come back in a couple of weeks.
I spent my free time while he was in the hospital, visiting him twice a day, and researching bladder stones and CRF. I found a wonderful group on Yahoo where I could seek information to help me understand this heartbreaking situation, and guide me as I trudge down this road filled with hidden potholes and many, many blind curves. Some of the things I learned were the need to watch phosphorous levels and administer sub q fluids. Importantly we must treat the cat, not the results on the blood test. At his follow up vet visit, I suggested that I would give him sub q fluids and she sort of showed me how. And this began another journey down a different road. One I never thought I would be able to navigate. I am truly needle phobic, if that helps build a better picture as to what we were facing. The thought of getting him to stay still while I inserted a needle under his skin, filled me with a lot of doubt concerning my abilities but knowing that this was the only way to keep him healthy, has been all the motivation I need.
Sub q fluids, for those who do not know, require that I hang a bag of fluids (the type you might receive if you were in the hospital) and then insert a needle just under his skin. There are two types of fluids, the Lactated Ringers solution, and Normosol -r. Supposedly they are one in the same. But in reality they are not. When we began the Sub q fluids it was with the LRS fluids. Nightmare did pretty well with those. Then the new vet put him on Normosol -r, because that is all they carry. What I first noticed was how the Normosol - r had a smell, whereas the LRS did not. Then as the fluids went in sometimes Nightmare's back would twitch. And sometimes he would turn and try to rip the needle out. Apparently Normosol - r is painful to some cats and Nightmare happens to be one of them. Now we are using only the LRS, and 20 gauge needles. We started out with 18 gauge needles which resemble miniature whale harpoons. The 20 gauge makes the flow a little slower I guess, but that is a very small price to pay for a bit of comfort.
Within a week of beginning the sub q fluids I changed vets. He is now going to a vet at the 24 hour animal hospital. A vet I spoke to when he was a patient there. She is much better and much more proactive than his previous vet. Some vets just don't get the whole CRF thing. Like how it can be managed, and how it does not have to be the end all until the Kidney's totally cease functioning. One must remember that a vet is just like any Doctor and if we feel they are not meeting our needs we need to take it upon ourselves and find one who will.
A lot of turmoil resides in the fact that since he was first diagnosed his blood levels have fluctuated. They went down after the IV treatments, then back up again, then down after I began Sub q's, and back up again a couple of weeks later. As of the last test, they have decreased a little which is good. His appetite has improved as well since I found a renal formulated diet he will eat. And he gets .25 of a Pepcid AC pill each day, to combat stomach acid which most CRF cats have. We also have gone from every other day fluids at 100ml, to every day fluids at 150ml.
For the curious this is how our day starts:
I get up an hour earlier than I used to in order to get everything done and get me off to work. Upon getting out of bed, I place his bag of fluids on a heating pad and wrap it up in blankets. Because who would want to be pumped full of cold fluids?
While the fluids warm up, I get his canned food out of the fridge. Then I cut a Pepcid AC pill into quarters. I then crush the pill up and mix it with a spoonful of canned food (such a small amount to insure he eats all the Pepcid AC). While this is going on Nightmare sits on his scratching post watching me and patiently waiting. Who knew cats could be patient?
After the fluids are warmed up I hang the bag on the shower rod and then test the flow and the temperature. I then line up all his different treats on the bathroom sink. We have numerous treats because he never knows which treat might be the one he wants until he sniffs it. I then situate myself on the side of the tub and Nightmare stands between the sink and the tub. I drop a treat in front of him and as he purrs I brush his back (helps to desensitize the area) and then quickly insert the needle just under his skin - if I am lucky that is. Too far in could mean hitting muscle and well …. he is not appreciative of when I do that. While the fluids pump in, he eats his treats, or I brush him and we wait until he has received all his allotted fluids for the day. An important thing to know is that I must keep one hand on the cat at all times, or he might decide we are done and walk away, leaving fluids to spew all over the bathroom. Been there done that. After we are done I remove the needle and pinch the spot where the needle was inserted to help keep the fluids from leaking out. Usually now is when he walks away and goes straight to his scratching post, although lately he has been hanging around rather than walking away … I think he is enjoying the experience more.
Next, I get his breakfast ready. By this time he is back to sitting on the scratching post. I pull another post over to him so I can set the saucer with the spoonful of canned food and Pepcid AC mixture in front of him. This setup frees me from having to hold the saucer while he eats which is what I was doing until we worked this new improved method out. Once he finishes eating all the canned food he wants, he wanders off to snooze on the couch and I am off to work.
All in all I think we have a good system worked out.
Next vet visit is on Wednesday … I am hoping for the best of course. We shall see.
One day he was fine, eating and being his normal self. The next day he didn't get up with me, and he was not real interested in food. A couple of vet visits later, and he was admitted to a 24 hour animal hospital for IV fluids. The vet there told me upon admitting him that given the unbelievable levels on his blood test, if he had been a dog he would have been dead. But, he is not a dog and like cats everywhere he had other ideas. After numerous test, which included an ultrasound, they found he had bladder stones, and possibly a blockage may have caused the entire fiasco. After a week in the hospital I took him home and followed up with his regular vet. She really wasn't doing anything, and his blood levels were going up again - she only suggested I come back in a couple of weeks.
I spent my free time while he was in the hospital, visiting him twice a day, and researching bladder stones and CRF. I found a wonderful group on Yahoo where I could seek information to help me understand this heartbreaking situation, and guide me as I trudge down this road filled with hidden potholes and many, many blind curves. Some of the things I learned were the need to watch phosphorous levels and administer sub q fluids. Importantly we must treat the cat, not the results on the blood test. At his follow up vet visit, I suggested that I would give him sub q fluids and she sort of showed me how. And this began another journey down a different road. One I never thought I would be able to navigate. I am truly needle phobic, if that helps build a better picture as to what we were facing. The thought of getting him to stay still while I inserted a needle under his skin, filled me with a lot of doubt concerning my abilities but knowing that this was the only way to keep him healthy, has been all the motivation I need.
Sub q fluids, for those who do not know, require that I hang a bag of fluids (the type you might receive if you were in the hospital) and then insert a needle just under his skin. There are two types of fluids, the Lactated Ringers solution, and Normosol -r. Supposedly they are one in the same. But in reality they are not. When we began the Sub q fluids it was with the LRS fluids. Nightmare did pretty well with those. Then the new vet put him on Normosol -r, because that is all they carry. What I first noticed was how the Normosol - r had a smell, whereas the LRS did not. Then as the fluids went in sometimes Nightmare's back would twitch. And sometimes he would turn and try to rip the needle out. Apparently Normosol - r is painful to some cats and Nightmare happens to be one of them. Now we are using only the LRS, and 20 gauge needles. We started out with 18 gauge needles which resemble miniature whale harpoons. The 20 gauge makes the flow a little slower I guess, but that is a very small price to pay for a bit of comfort.
Within a week of beginning the sub q fluids I changed vets. He is now going to a vet at the 24 hour animal hospital. A vet I spoke to when he was a patient there. She is much better and much more proactive than his previous vet. Some vets just don't get the whole CRF thing. Like how it can be managed, and how it does not have to be the end all until the Kidney's totally cease functioning. One must remember that a vet is just like any Doctor and if we feel they are not meeting our needs we need to take it upon ourselves and find one who will.
A lot of turmoil resides in the fact that since he was first diagnosed his blood levels have fluctuated. They went down after the IV treatments, then back up again, then down after I began Sub q's, and back up again a couple of weeks later. As of the last test, they have decreased a little which is good. His appetite has improved as well since I found a renal formulated diet he will eat. And he gets .25 of a Pepcid AC pill each day, to combat stomach acid which most CRF cats have. We also have gone from every other day fluids at 100ml, to every day fluids at 150ml.
For the curious this is how our day starts:
I get up an hour earlier than I used to in order to get everything done and get me off to work. Upon getting out of bed, I place his bag of fluids on a heating pad and wrap it up in blankets. Because who would want to be pumped full of cold fluids?
While the fluids warm up, I get his canned food out of the fridge. Then I cut a Pepcid AC pill into quarters. I then crush the pill up and mix it with a spoonful of canned food (such a small amount to insure he eats all the Pepcid AC). While this is going on Nightmare sits on his scratching post watching me and patiently waiting. Who knew cats could be patient?
After the fluids are warmed up I hang the bag on the shower rod and then test the flow and the temperature. I then line up all his different treats on the bathroom sink. We have numerous treats because he never knows which treat might be the one he wants until he sniffs it. I then situate myself on the side of the tub and Nightmare stands between the sink and the tub. I drop a treat in front of him and as he purrs I brush his back (helps to desensitize the area) and then quickly insert the needle just under his skin - if I am lucky that is. Too far in could mean hitting muscle and well …. he is not appreciative of when I do that. While the fluids pump in, he eats his treats, or I brush him and we wait until he has received all his allotted fluids for the day. An important thing to know is that I must keep one hand on the cat at all times, or he might decide we are done and walk away, leaving fluids to spew all over the bathroom. Been there done that. After we are done I remove the needle and pinch the spot where the needle was inserted to help keep the fluids from leaking out. Usually now is when he walks away and goes straight to his scratching post, although lately he has been hanging around rather than walking away … I think he is enjoying the experience more.
Next, I get his breakfast ready. By this time he is back to sitting on the scratching post. I pull another post over to him so I can set the saucer with the spoonful of canned food and Pepcid AC mixture in front of him. This setup frees me from having to hold the saucer while he eats which is what I was doing until we worked this new improved method out. Once he finishes eating all the canned food he wants, he wanders off to snooze on the couch and I am off to work.
All in all I think we have a good system worked out.
Next vet visit is on Wednesday … I am hoping for the best of course. We shall see.