Every day is like Monday

[gwyn]

One of the things that has been in the background during the past year while my sister was sick, when she died, and after the death that has added a lot of emotional baggage to an already pretty horrible situation was that my cat, Emma, got sick last year and I've been trying to find some way to make things better.



Sometime last year I changed her diet and her type of cat litter because she had started drinking three times as much water as before, and peeing like a racehorse, and I didn't want to keep breathing the clay clumping litter dust at that level, because it contains potentially cancerous chemicals. I figured with what was happening to Sis_r, I really didn't want to be adding to my potential cancer development. (I actually wrote a pretty funny article about this whole thing that didn't get published. Maybe some time I will post it here.) The diet change had a huge effect on her, but she was still thirstier all the time and so I finally took her to the vet in January, when it looked like I would have a job for at least a few more months. She didn't have diabetes, which was my biggest worry, but her thyroid levels were twice normal, and they said it could often mask kidney disease so I had to put her on a low-protein diet. They gave me this medicine that, since I can't give her pills (or at least, not with the expectation that I can keep my fingers), I could rub on the inside of her ears. She loves to have her ears rubbed, so that was cool. All this info was going on while I was in San Diego, and my sister was getting worse, so I had a hard time absorbing everything, but people were nice, and the pharmacy that made the suspension even would mail the prescription for me and I didn't have to do a thing.

I started her on the medicine right before the last series of trips to SD, and she seemed okay at first, but then became violently ill, and couldn't keep anything down. The poor thing was vomiting constantly. I went on the web and sure enough, there was all this stuff saying that some cats have very bad reactions to the meds, and so I took her off it and she stopped vomiting. The vet argued with me, saying that she had never heard of that and it wasn't the diet or the meds. I was really annoyed, and when I brought her in to be retested to see how she was doing, they still insisted it was something else. Her levels had dropped down, but she has always been afraid of the vet's more than most cats, and when we left that time I thought Emma was having seizures -- she began hurling herself violently around the carrier.

I got her a soft sided carrier, began giving her the meds in lower doses again, and she didn't vomit, but her ears started festering and she would cry and run away from me when I got the stuff out. After my last trip to SD, I was too worn down and sad to keep doing it. Even if her thyroid levels were down, she was in pain and miserable, where before she'd been happy, fat, and healthy except that her thyroid was bad and she peed a lot. You would never know, though -- she was perkier because of the better diet and acting like a kitten most days.

Emma's been the only thing that has kept me going through a lot of this. There've been plenty of days where if it wasn't for her, I'd just as soon drive off the Aurora bridge or accidentally take too many of the Darvocets I brought home from my sister's stash. The last thing I needed to see was my cat, who is the only thing I have left, suffering in a situation like my sister's where the cure is worse than the disease. Her shots weren't due until this month, so I just decided to wait and find a new vet when the time came.

I asked around but I wanted a local vet. I'd taken my ex's cat Spike to this place before, and even though they don't have separate dog and cat entrances (Emma is rather... shall we say, psychotic, especially around dogs -- I've seen her go after German shepherds and rip their faces off), the guy seemed nice and he went to my high school, years behind me but I knew his older brothers and they had always seemed nice. The poor kid, though -- the instant she saw the carrier, she peed all over me even though she'd never traveled in this one. Strangely, it wasn't as heinous as most cat pee, but I got her in it and we went to the office, and they gave her a checkup and he used this thing on his hands called, I think, Feliway, which was a pheromone that calms them. It totally worked, too. The tech was really nice (he looks like Matt Groening), and he was really understanding about what a bad year Emma and I have both had. He had to take her away a couple times and I warned him about how violent she was, but he said she was nice -- I have a feeling he was just trying to soothe me, but I hope she wasn't as bad as usual (one vet's office gave her to me and said "Please get her out of here now!"). Unfortunately, they needed a urine sample, and rather than use a needle, they said they could put her in a cage and keep her for the day, and not be invasive, so I left her, which was hard.

She is not adaptive at all. Most cats adapt. Not Emma. I've seen her tear parts of her body off trying to get out of a situation she doesn't like -- ripping claws out, etc. She gets very worked up and frenzied, and even though everyone says "radioactive iodine treatment," I haven't wanted to think about it because it means she has to be in a cage in a place for days. Here, they told me they could keep her carrier in the cage with her so she'd feel more comfortable, but when I called in the afternoon, she still hadn't peed, and I thought that was odd. Turned out, she peed in the carrier. All day. I didn't know till I got home and found wetness and saw a streak on the car seat. She had been squashed up against the mesh wall all the way home, and I couldn't undertstand it, until I realized she'd been trying to get away from the soaked pad. Poor bug.

So days in a cage and a long ride up to Edmonds... I don't know. It sounds easier than it will be. She's not going to be able to do a ride that long easily, not without peeing, and if she pees at the mere sight of the carrier... arg. It's very expensive, but that's not the issue, the issue is that my cat will be away from me, and she is the only thing I have left, and if something happens to her, I can't take it. But if I don't do anything, she could die, too - kidney disease, which underlies the thyroid right now, or a stroke, or a little kitty heart attack. It just hurts to think of causing her so much fear and pain.

The doctor is going to give me all the info later though, when I bring her in for a blood pressure. He was really informative, much more so than the other office, and told me what he did with his geriatric cats, and explained why, for instance, her urine isn't that smelly compared to normal cat urine. He thinks she is doing very well so it's not that big of a hurry. He's more worried about kidney disease progressing, which is why he wants to see the thyroid treated, and he really agreed with me that if a cat's vomiting or her ears are festering sores, medicine not such a great idea. He even explained all the different reasons for the vomiting. I guess it's my nature, or maybe my training but I really value a lot of info, even if I don't always understand it. And the tech was so kind to her, and that really made a difference for me.

So, now I have to figure out when to do this, probably after the new year, but then I get into the time last year when Sis_r was sick, and... when I went out last night to get something, I wore a jacket I could have sworn I'd worn since March, but there was the boarding pass of the flight I took that weekend after she died. All this stuff with the vet, and little reminders, and it feels so much like it's happening again, me being helpless to help someone or something in pain.

I think most people would have thrown a cat like Emma back a long time ago. She's mean and cranky, not affectionate in a traditional cat way. feochadn says she has a three-pet limit, and that's true. She bites and scratches and won't ever sit on a lap. I have pretty bad scars all over from her attacks, and you never know when they'll come. But most of the time she is very loving in an odd way to me. She talks all the time, she purrs all the time, and she likes to sit somewhere in the same vicinity as me. Everything scares her, except dogs or other cats, which she tries to kill. But she is curious and loves to get into things; there are items I've lost forever because she takes them and carries them away. For years she's had a passionate affair with her flea comb, carrying it around, talking to it. She's funny and a good sport most of the time, and really really cute. I know it was very hard for her, me being away so much this past year, strangers taking care of her and being so lonesome and bored.

And she's everything to me.I had a really bad review yesterday at work, and she was there wandering around behind my chair, chatting away with me while I listend to all the reasons I'm a terrible human being (you know, it's weird -- I get asked to speak at conferences, I keep getting job offers, I have been doing this for 24 years and proving that I am successful in my field, and I still have to have goals and objectives to be a better person so my company can treat me like shit... human resources and employee performance reviews are the biggest jokes in the entire working world, if you ask me). I feel like the only reason I'm staying at this job is so I can keep Emma in cat litter and because the radioactive iodine is expensive, but honestly, once we're out of probate, I could pay for it no problem.

It's just been... hard. Having a sick kitty while my sister was sick, trying to deal with making her feel worse when I was at my lowest point ever... and now coping with a job I hate and how demoralizing fandom has felt for me lately -- I rely on Emma more than ever, yet I fear that I'm not doing right by her, no matter which direction I go. I'm scared that either way, there's a bad outcome ahead, because so far, that's the only outcome I've ever experienced when it comes to sickness.

I have a picture of her but I can't remember how to do pictures here, and I am having too much emotional trauma to figure it out.

Comments

[movies-michelle.livejournal.com]

I'm sorry to hear about Emma's worsening. It sounds like you've found a good vet, though, even if he is a distance. Hopefully this will help. I'll think good thoughts for you guys.

[fishsanwitt]

I'm thinking good thoughts for both you and Emma.

::hugs::

[merricatk.livejournal.com]

I hope this will help, but having been through this with sickness with an even half dozen cats in my adult life, having been the everything-you-can-do route and (most recently) the I'm-sorry,-Fred,-I-think-you're-dying route, one thing I can tell you is, whatever you're doing, whatever you find you *can* do, is the right thing. You're not failing her. You're loving her. You're fine. Really.

[elke-tanzer.livejournal.com]

My geriatric diabetic barf-o-matic one-paw-in-the-box-is-good-enough little high-maintenance fuzzball and I both send good thoughts to you and Emma.

I hear you. My cat has been with me through a stressful college degree, a marriage, ex-hub's cancer treatment, and a long-term relationship with former-SO, and she's still here. It's going to be rough when she's no longer with me, and I've been thinking a lot lately about how much I'm willing to put her through to keep her in my life. She's currently curled up in a ball in a sunbeam next to me, dreaming.

Hang in there, hon.

[chrisjournal.livejournal.com]

::pets::

(that's for you and for Emma).

We've got a rescue now (she came on Halloween last year) who earned her name: Cujo. She sounds a lot like Emma (travel issues, random fits, generally antisocial except with her owners, etc.), and I love her to bits. I kind of think it's like loving the most difficult child best, because you've been through so much together. She's thankfully young (probably about 2 years at this point), but I'd do and worry the same way you are. And it sounds to me as if you're doing *everything* you can for her, and that your mommy instincts are excellent.

We've been the route of geriatric pet health care twice in my boys' lives. Fred, my first and best roommate, had chronic kidney failure for 7 years before it finally got him. He was a puker, too. We never even had a vet suggest radioactive iodine treatments (maybe that's for the thyroid?), but I did have to give him subcutaneous fluids daily for a very long time (including the final months of a pregnancy in which I gained far more weight than was wise for my height/body type). < insert picture of horrifically gravid woman sitting on large cat to hold him down while sticking a #22 needle in his scruff >

Then there was the rescue basset hound. Poor Red Ryder had issue after issue. He was dog-aggressive and a little bit man-aggressive from the beginning, and we soon discovered that he had some kind of a chronic skin condition. We eventually did switch vets over this one, as that vet never came up with anything for us to do other than give him thyroid pills and dip him in poison (used for demodetic mange, which to this day I don't know whether he really had it or not). The new vet had us put him on a lamb/rice diet, and when the outbreaks came back again, we didn't get the poison, but a referral to accupressure for doggies. My family and most of my friends thought I was insane for doing it, but we drove him 1.5 hrs down to Woodwhateverthetownwas weekly for treatments. Not cheap, but worth every penny. He went deaf, became mostly blind, lost all bladder control (and way too much weight) by the end, but he didn't have another outbreak in the next 9 years with us.

You're not crazy, and you can only do as well as the information given to you by your vets. Emma's got the best mom she could possibly have (and I'll bet she knows it). Oh! The pet carrier thing: you can line the carrier with baby diapers to help with the pee issue on the long drive. It'll absorb the urine so she doesn't get wet and miserable. I once tried having Cujo loose in the car to see if that would help her travel issues, but it really didn't help at all. Nature's miracle is also wonderful for cleaning up urine, if that becomes an issue for you.

::good luck::

[gwyn-r.livejournal.com]

I meant to respond to this ages ago, but I plumb forgot. But I wanted to tell you that the diaper thing is just brilliant. I never ever would have thought of that. I have no idea what she will make of them , but I will rest easier, and I'm even saving my dry cleaning plastic bags so I can put them over the seat. Protection everywhere!

[ixchel55.livejournal.com]

Damn, I feel your pain (at least in a small way).

I have a 20 year old cat named Mr. Bones (which was a joke when I named him because he was a lanky, boney teenager.) But now he lives up to his name.

About two years ago he started throwing up constantly. He couldn't keep anything down. I took him to the vet, she commented on his lack of weight and tested him for hyper-thyroidism (which he didn't have at that time).

I finally found a food he keeps down (Iams canned - but not the beef), but for over a year he remained a really skinny cat (but otherwise fairly healthy - just old). Then he got very sick (constant vomiting, bad diarrhea, glassy eyed). So bad I was thinking about having him put to sleep because his quality of life was shit. I could look in his eyes and see he was miserable.

I put off taking him to the vet for a couple of days because it always traumatized him so badly and he's so old and frail. But the morning I woke up and said 'This is it. Vet day. Kill or cure,' he had a turn around. He's still so frail, almost skeletal, but otherwise bright-eyed, aware and seemingly happy.

But now he's doing the same thing as your Emma, drinking water constantly, peeing like a race-horse. I know that it's his thyroid, that's probably what's keeping him so skinny. I just have to convince myself that I won't kill him by taking him to the vet to cure him.

I think I'll call the vet and see if there's a mild tranquilizer I can give him for the trip (short though it is). But then I have to wonder about the vomiting thing that you said poor Emma went through with her meds. His tummy is delicate and unpredicatable to begin with.

At least I didn't have a desperately ill family member through all of this.

*hugs you*

I know the next couple of weeks are going to be hard. Just hold on and know that there are many people who care about you.

[aukestrel.livejournal.com]

HR departments are one of the stupidest, most stupidity perpetuating self-justifying bureaucracies in the world, except for maybe the IRS.

::kicks HR for Gwyn::

Actually the kidney disease is not necessarily or quickly fatal. I had a cat who lived over a year after the first vet told us she would be dead in two weeks. It sounds like Emma is really good at keeping herself hydrated.

You can check into certain things if she does turn out to have kidney disease, like putting a phosphorus binder in her food to lighten the load on her bloodstream and kidneys.

It's also safe to give cats Pepcid AC. The tablets are tiny, and the normal dose for a small cat is a quarter-tablet. It helps them with acid stomach and nausea. You can give up to a half a tablet if Emma is, say, bigger than 6-7 lbs. Make sure it's Pepcid AC plain - the famotidine - not the chewable ones. The amt is so small that you can crush it between two spoons and put it in tuna juice or something and she won't balk at it.

[abrakadabrah.livejournal.com]

I've read about phosphorus binders, but don't know what they are yet? Is it presciption only? Is it a powder you mix in the food?

[aukestrel.livejournal.com]

The one I used with great success was Alu-Caps, aluminum... something. You could (can?) get it at http://www.medichest.com and it was very easy to dose - a tasteless white powder and I think you used one capsule, which was 500mg, for 5 lbs of cat. Much easier to get down a cat than the liquid AlternaGel, which you can sometimes find in drug stores. The AlternaGel is an alternative but it's very slightly mint flavoured so it wasn't big with the cat who needed it the most. You most definitely do not want to use Maalox or things like that because a) cats hate it and 2) I seem to recall Maalox actually has something that's not good for kidney disease in it.

[aukestrel.livejournal.com]

If you go to my LJ under tags and choose feline_crf, there are a few posts in there that set out exactly what I did and used. This is the specific post for the Pepcid AC and phosphate binders and so on:

http://www.livejournal.com/users/aukestrel/32211.html

I have just discovered they stopped making Alu-Caps, but I checked the links and there is still a lot of current info at this link that will help you get phosphate binders in a form your cat will actually agree to ingest:

http://members.verizon.net/~vze2r6qt/supplies/binders.htm

[umbo.livejournal.com]

This definitely sounds like a very difficult situation, with lots of difficult choices, but I can tell how much you love your kitty by reading it, so I know whatever you decide will be the best choice you can make. Not that that makes it any easier, of course.

*lots of hugs*

[leela-cat.livejournal.com]

Feliway is magic stuff. We use it in a diffuser and it stops us from having to give Monster meds (and lets us keep our fingers). It comes in a spray that you can use on your fingers or to spray into a carrier before you put a cat into it.

Emma sounds much like our dearly beloved bitch queen cat Ozone. The symptoms were much the same, and she was also allergic to the medication the vet gave us for her looming kidney issues. Actually, she was allergic to the gel that was the delivery mechanism. OTOH, our vet believed us when we told him.

One thing I did do with her, which worked very well for many years, was to give her foods that included a potassium supplement. Our vet told us that one of the signifiers of kidney disease is low potassium, and Ozone's was seriously low. I had to spend some time looking at the ingredients list on the foods we fed her. Look for foods that include potassium as a supplement, not just a preservative. (This usually means two types of potassium, with one earlier in the list). Royal Canin (Mature/Senior) was the one we settled on. I also found that some canned food include potassium as well. The most surprising thing was that not all senior cat food had a potassium supplement.

As for Ozone, she had a mostly happy and healthy 2 to 3 years after we put her on the potassium supplement. When she finally died, it was cancer, not the kidney disease that had threatened her all those years earlier.

As for the other part, if you care about Emma, if you're taking care of her, if you're making sure she gets good food and good care, then you're doing right by her. If she continues to eat and she continues to be as affectionate as she ever was, then you're doing right by her.

When it's time, she will let you know. Both of our elder cats did that most determinedly.

[avidrosette.livejournal.com]

I'm sorry to hear your cat is unwell. For what it's worth, here are some experiences I had nursing two cats through kidney disease and another through thyroid disease, sort of learning from my mistakes as I went along.

The most important thing I found was choosing a vet who was AAHA certified. (That's the American Animal Hospital Association.) They visit vet's offices and have very stringent requirements for certification, which relatively few veterinary practices meet. They publish a list of certified offices. The quality of care my cats got jumped tenfold when I switched to AAHA-approved doctors.

With regard to the kidney disease, my cats were both given blood tests at regular intervals to determine both that they did in fact have the disease, and also how it was progressing. I was told that there was no real treatment for the disease, but that the low protein diet could prolong the cat's life. My vet also said that the excessive drinking and peeing was actually an adaptive mechanism of the cat's body, not something to try to curtail. One of my cats lived for years with the disease, and seemed relatively happy and comfortable aside from the drinking/peeing. She needed intravenous fluids at the end, just as another commenter mentioned above.

With regard to the thyroid disease, we used tapizol (sp?) pills for awhile, and then did the radiation therapy. (The vet did a full body x-ray first to make sure the cancer hadn't already spread.) The radiation treatment worked, and the cat's thyroid levels went back to normal after the treatment (and the cancer didn't spread). Even though it was expensive and a huge pain - the nearest treatment facility was four hours away, and involved an overnight motel stay with the cat - I believe the treatment extended the cat's life by years. The caution with it is of course that the cat is radioactive for some time after the treatment. (I seem to remember I131 has an 80-day half life.)

I wish you the very best of luck with Emma. My cats were my lifeline when I lived alone. I know how very dear she must be to you.

[par-avion.livejournal.com]

*hugs*

I have no advice. But I wish you and Emma well.

[mlyn.livejournal.com]

*Hug*
It sounds like your new vet is totally awesome. What other people have said is absolutely right: you doing everything you can to help her is exactly what she needs. By taking her to a new vet who is doing better things for her and you, you're living up to that good-pet-owner status. You're not superhuman and can't fix things with a snap of your fingers. Damn, don't I wish.

BTW, you may say she's a cranky cat and hard to live with, but I think she's great. People just have to know their limits with her.

I'm really looking forward to seeing you and Emma in the next couple of weeks. I had a dream about you this morning, so I think it's time we caught up. Evidently my mind is yearning for that.

[abrakadabrah.livejournal.com]

My cat has just been diagnosed with some kidney disease, too. Sigh. It's not too bad yet, but I'm having some trouble switching him to the low phosphorus food. For anyone in a similar situation, here (http://webpages.charter.net/katkarma/canned.htm) and here (http://webpages.charter.net/katkarma/canfood.htm) are listings of cans by phosphorus content. As I understand it, it is the phosphorus element of the protein that is the problematic bit in the food, causing the kidney disease. But it only shows up in cat's bloodtests and symptoms once it has already progressed quite a bit.

I'm working on getting my cat to eat the food; So far, in the last week, since I found out, I've tried mixing in his old food with the prescription food, which he finds just palatable, cooking homemade for him, which hasn't impressed him much despite the fact that I got the omega 3 oil and taurine tablets to add in, and also trying the human grade cat food which is low in phosphorus. He doesn't much like it though, (I tried him on it before he was sick as well, and he didn't like it then much either). It's a bit of a trial, since I read keeping him well fed at this point, is also important.

I really wish the damn vets would tell you, before the cats get sick, about how prevalent kitty kidney disease is and what not to feed them to prevent it. It would save a lot of pain afterwards.

OTOH, as per avidrosette's advice, I just looked up my vet, and they are AAHA approved, which is good to know, since I never know how good they are. And now I won't have to change. It's just a short drive away and very convenient.

[aukestrel.livejournal.com]

Those are great resources! My cat did very well on the Wellness. We mostly fed the chicken and turkey varieties - I felt much better about feeding her that than the k/d because the k/d had gritty stuff in it and byproducts that I just was not happy feeding an already overloaded system.

I'd also advise you to find a phosphate binder - it really helped my cat a lot.

If you go to my LJ under tags and choose feline_crf, there are a few posts in there that set out exactly what I did and used. This is the specific post for the Pepcid AC and phosphate binders and so on:

http://www.livejournal.com/users/aukestrel/32211.html

I have just discovered they stopped making Alu-Caps, but I checked the links and there is still a lot of current info at this link that will help you get phosphate binders in a form your cat will actually agree to ingest:

http://members.verizon.net/~vze2r6qt/supplies/binders.htm

[abrakadabrah.livejournal.com]

Thanks for the informative replies. It's really helpful.

I notice on one post you wrote your vet told you to keep doing the herbs. What herbs?

[aukestrel.livejournal.com]

She went through a period when she just wouldn't eat and I started to syringe feed her a slurry, basically. So I was able to get these down her but most of them were not things I could have gotten down her just mixed into her food. A lot of this was just geared toward getting her digestive tract up and running again. She weighed about 6 lbs at this point so I tried to syringe feed her about 30-50 ccs of slurry 3-4x a day (they need small frequent meals to counteract the nausea too).

She was in acute renal failure at this point and we still don't know *why*; but once she passed the crisis point and started eating again, I cut out the herbal slurry unless she started to refuse her food or get constipated. I mixed the herbs and things with some cat food in the food processor so it was as smooth and liquid as possible. THe cat food was for nutrition and to hide the taste, and this was one reason I switched her to the Wellness brand, because it would process down into a smooth paste and the Hill's k/d would still have these little gritty *chunks* that really just nauseated me. *g*

1/4 tsp psyllium in 1 tsp of water (or more - psyllium gets really thick really fast). This was to bulk up her stools and help her with the constipation.

1 tsp of lactobacillus acidophilus liquid - you could use anything, even live culture yoghurt. I was trying to maintain a beneficial bacteria count in her digestive tract with this.

1000mg fish oil - she liked this, so yay. I was able to put this in her food even after she started eating again. I think this was for the nutritional value but probably also for the oil.

1/2 - 3/4 tsp slippery elm powder - this is the stuff you'd never get down her on a regular basis; it's got a distinctive odor. But for the slurry it worked. Slippery elm soothes the digestive tract and heals it, and can be used without harm in cats, so I added this in to help with the stomach acidity.

1/4 Pepcid AC - this was for the nausea and she was basically on the Pepcid AC until she died. If she was having a bad day, I'd give her half a one. It really helped with the nausea. I also discovered that it made them nauseous to put their heads down to eat and drink so for a long time she ate and drank on a small cardboard box, about an inch and a half high.

A few drops of aloe vera juice - again, this is bitter and not something you'd get down a cat by mixing it in her food but it tones and heals the digestive tract too.

I also used bottled or filtred water to mix the slurry and in her water bowl, and while she was in acute renal failure she was getting 100 ml of lactated Ringer's solution subq every day too.

[aukestrel.livejournal.com]

I should add that the vet said none of the herbs would hurt and because her numbers were so much better to keep doing them, but he felt that the subq fluids and the phosphate binders were the most important, and I agree. The advantage of the phosphate binder is that it goes right in the food so the cat ingests it along with the food and it binds the phosphorus then and there so it doesn't have a chance to get in their bloodstream.

He is a great vet, very encouraging. He said that cats are just as individual as people and what's a "high" number for one cat is a number that another cat doesn't seem to notice, and that was certainly true for Allie.

sympathy

[klytaimnestra.livejournal.com]

I'm so sorry about the cat, and about your sister, even more. I hope the cat can pull through; it sounds as if you're doing everything possible, and the little cat is in the best hands she can be. Maybe it would be a good thing to phone up one of those job offers and ask if they've still got an opening; you don't need the extra stress of a sucky workplace. Though change is stressful too.

You'll be in my thoughts.