I went to see the locum to chat with her and I was actually very impressed. She said she loves cats, especially older ones and has a 21 year old cat herself and is giving her 100mls a day sub cuts, so we discussed what to do and what had gone wrong. She is sure the diuretic is making Swampy feel worse and suggests that 1/8th of a 40mg tablet should be enough - a little more if and when I give more sub cuts. She thinks I will have to, as he is deteriorating and 50mls a week isn't really enough. Swampy is not very dehydrated on the skin test, but he's started crying for water when he can't instantly find it so he must be very thirsty. Mind you, he seldom drinks for very long or drinks very much and still does his polite little wees. I wish I had seen her before starting the sub cuts but that's how it goes.
Anyhow it helped to have a chat and I explained the reasons for certain meds and she seemed to understand that management of the elderly with multiple health problems involves compromising on meds. In an ideal world Swampy wouldn't take anything that hurt his kidneys. I am going to stop his antibiotics from tonight though as we spoke about how his stomach is battling with them and needs a break.
He's been on them a month and they help his cold tremendously. She also didn't seem phased when I said they helped his vestibular disease - she said she'd use them to control it too.
I have to give him his laurabolin injection soon so am nervous about that - she didn't seem totally familiar with it but looked up his notes to see the right dose.
thanks again for all the support