Topic: RIP baby Max: PLEASE READ UPDATE THREAD (Read 97204 times)

Gillian Harvey · « **Reply #430 on:** June 23, 2009, 15:53:44 PM »

Quote from: swampmaxmum on June 23, 2009, 12:43:39 PM

I'm tired of being made to feel a freak for doing something so routine elsewhere and doing palliative care.

There are so few vets in the UK who offer owners the chance to do subqs at home, but its not that they don't know that it can help in so many cases, its more they don't think owners could cope I suppose. My vet was ok about me doing it, but I had to ask her if I could, it wasnt offered.

Angiew · « **Reply #429 on:** June 23, 2009, 15:25:14 PM »

Quote from: swampmaxmum on June 23, 2009, 12:43:39 PM

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I'm tired of being made to feel a freak for doing something so routine elsewhere and doing palliative care. Sorry to sound off, but I'm quite upset. Max ate, wee'd normally, had a play and a good purr this morning. What's wrong with making sure he can do that for as long as possible?!

Don't be daft. Its up to every individual owner how much they do.
It also depends on the cats temperament as well. I honestly don't think I've had a single cat with the right temperament.

I probably could not do what you are doing (never say never!) and you must be feeling totally exhausted.

sheryl · « **Reply #428 on:** June 23, 2009, 15:24:46 PM »

There is nothing wrong with what you are doing sweetie - dont let it get you down. Your love and devotion to your boys is an inspiration xxx

Love, huggles and positive vibes for your gorgeous boys and a big

for you Hun xxx

swampmaxmum · « **Reply #427 on:** June 23, 2009, 12:43:39 PM »

He ate better this morning, thanks. He saw the vet (Swampy's home visit) and disappeared fast! I tried to discuss the fluids amount as well with the vet, but no good really. He just says no-one else does for their cats what I do. That isn't true - if you look at the CRF yahoo group and generally in America, so many owners are doing sub cuts and I'm sure that here (maybe not around here or in London) others are doing the same.
I'm tired of being made to feel a freak for doing something so routine elsewhere and doing palliative care. Sorry to sound off, but I'm quite upset. Max ate, wee'd normally, had a play and a good purr this morning. What's wrong with making sure he can do that for as long as possible?!

clarenmax · « **Reply #426 on:** June 22, 2009, 18:23:41 PM »

Sendng some more

hope Max eats better tonight and tomorrow xx

Leanne · « **Reply #425 on:** June 22, 2009, 18:15:02 PM »

I'm just catching up on this but

to you all

swampmaxmum · « **Reply #424 on:** June 22, 2009, 09:37:28 AM »

thanks and thanks Philip, I know the pain is still raw for you so thank you for your help too. I have a very deep bond with both my boys which as you say, gets much stronger when you nurse them intensively.
Poor Max. He hadn't pooed last night at 11 so I topped up his dose of lactulose, then 5 mins later he went big time, so early this morning he had a bit of a runny tum. Not much but he's not eating very well this morning and is miaowy so I hope it is just that and I haven't inadvertently made him worse.
You are right too in that being on hyper alert for any problems is draining. I feel about 200. But I know it's not for ever and it must be done for them. They have always been there for me for 15 and 17 years.
I wish the vet had more experience of home sub cuts as I do feel a bit abandoned and am having to get advice (mostly good) from the CRF yahoo group instead. My vet said 50mls a day for Max. If I'd just given him that, he would have passed on by now.

Anyhow I hope he will be calmer and eat more later. I spend ages just cuddling him, but I need to cuddle Swampy too. The way they both like affection and love is different as well.

Bazsmum · « **Reply #423 on:** June 22, 2009, 09:25:36 AM »

Thinking of you and the boys!

Desley (booktigger) · « **Reply #422 on:** June 22, 2009, 07:53:14 AM »

SM, you will struggle to get Liquid Paraffin, chemists aren't selling it anymore, and selling Lactulose instead as it can be very harsh. SEB can be used for constipation.

Philip · « **Reply #421 on:** June 21, 2009, 23:15:29 PM »

I gave 5 mls twice daily via a small syringe.

Lactulose didn't work at all with Tiffy but Liquid paraffin was great.

It softens the stool so allowing the cat to pass it more easily.

You will find as the disease progresses, that its easy to get so caught up in it all that you feel completely washed out.

Sometimes monitoring the cat minute by minute.

In end stage renal failure the nursing care can become really intense so take care of yourself.

It can be so easy to get focused on the CRF and forget to just sometimes enjoy just being with them.

I had 2 years with Tiffy after he was diagnosed with CRF. Just 2 months with my lovely Maddy.

As long as max keeps having more good days than bad and the intervention he needs isn't so intense that he resents it and you feel its cruel to continue then you are doing the right thing. I developed such a close bond with my CRF cats through all the feeding and sub q fluids and by the huge amount of time I spent with them. Its clear you have such a special bond with Max too.

I do hope you still have a long time still together.

I miss my Maddy so much right now. I cant get over how fast this horrible disease can progress sometimes. Its so bad that cats don't show symptoms till there is only 25% function of the kidneys left. Even blood tests don't necessarily pick it up in the early stages due to the bodies ability to compensate.

swampmaxmum · « **Reply #420 on:** June 21, 2009, 22:43:08 PM »

what dose do you use of liquid paraffin please? I'll have to try that if lactulose doesn't work very soon. I don't want to give him too much as he is not eating a great deal but I think he must be feeling a bit off from not going.
I have noticed a slight increase in his anxiety this afternoon and evening - he's never been a relaxed cat anyhow - like if the telly is loud, he gets upset, leaves the room and hides. He does respond well to being made a fuss of though. I'm feeling quite anxious as one day at a time is quite stressful with kidney failure. I wake up in the night wondering if he is ok and will be ok today and so on.

Philip · « **Reply #419 on:** June 21, 2009, 15:32:35 PM »

lactulose takes a few days to work.

I would reccomend liquid paraffin as I had much better results with that than lactulose which is in essence. sugary syrup.

swampmaxmum · « **Reply #418 on:** June 21, 2009, 11:53:37 AM »

Many thanks Philip. I haven't started it yet as am using the end of the Hartmann's bag and am then going to switch. However the sodium seems higher on the lactated ringers I got than the Hartmann's according to the bag (sodium 147 Aqupharm 9 bag and 131 Aqupharm Hartmann's). I know they use ringers in the USA as say it stings less, but now I'm a bit muddled as to which is right if sodium's so important. My vet only has 1 other patient on fluids and they aren't daily either.

I've started using the surgical spirit to disinfect the rubber port and the fluid drawing needle and I don't change that needle often. But I've decided not to use the butterfly needle more than twice. I do disinfect it with spirit, then wash it in boiling running water as the nurse suggested, but it seems to get blunter. Each needle costs £1.40 or something but it's a small price to pay for Max's comfort. He really is getting a lot of fluids and is absorbing them quickly - 60 - 70mls in the morning only leaves a hump for a short time, a 40ml injection leaves almost no hump, but today he has eaten a can of Applaws, had a play with me and is moving around normally so that is good. He is quite miaowy at times so I think that his numbers are probably not good, but he is happy in himself which is what we are trying to do for as long as possible. His weight is stable and his coat's good.

Then again the lactulose still hasn't worked. He didn't poo in hospital, then did a proper one on wednesday and not since, despite the fluids and eating a little can daily. I gave him 1.7mls lactulose last night and so far no result. I know Applaws has zero fibre but I suppose he should go at some point so I will have to regive the lactulose in 1.7 - 2ml doses until he does.
Do you think twice a week is ok? I'm just trying to keep him comfy. He seems to have gone off Hi life cat food which presumably has some fibre in it.

Philip · « **Reply #417 on:** June 20, 2009, 15:18:19 PM »

I draw up with one needle. Swap and inject with another or a butterfly. Then wipe the injection port with an alcohol wipe and re use the first needle to draw up from the bag and swap again to the other needle to inject.

My vet felt saline wasn't the best choice for CRF due to the sodium content.

This is my vets recommendation. None of my CRF cats ever got an infection using that method so thats what I would suggest to you.

swampmaxmum · « **Reply #416 on:** June 20, 2009, 10:45:21 AM »

Quote from: Philip on June 19, 2009, 23:14:12 PM

The vet I use specialises in cats and I only used Lactated ringers solution on her reccomendation. It is better than saline that contains sodium.

Hartrmans may sting more I have been told.

My vet only has Hartmann's 11 (sodium lactate, potassium chloride, sodium chloride, calcium chloride dihydrate, sodium lactate) or else the drip saline solution. I asked for lactated ringers but this is the choice I was given. So is it a third, separate option please? I am definitely going to ask for it. The CRF yahoo group (american) all use lactated ringers. So is there no or much reduced sodium in the ringers? Thanks Philip.

Max had 75mls this morning and his body just drank it in but he then ate nearly a whole little can of Applaws chicken breast. At present he is just eating early mornings then not really again but at least he is eating.
The vets told me that the needles can be re-used once or twice if run under boiling water (or first surgical spirit, then water as the spirit would sting) but I'm not sure, even though the butterfly needles aren't cheap. The nurse said the risk of infection sub cutaneously and always in the same cat is very low - what do you think? I would rather spend £5 a day on Max's needles than risk it I think.

weesilvie · « **Reply #415 on:** June 19, 2009, 23:25:52 PM »

Such a handsome chap, hope he stays OK

Philip · « **Reply #414 on:** June 19, 2009, 23:14:12 PM »

The vet I use specialises in cats and I only used Lactated ringers solution on her reccomendation. It is better than saline that contains sodium.

Hartrmans may sting more I have been told.

swampmaxmum · « **Reply #413 on:** June 19, 2009, 09:46:26 AM »

It's become clear to me that the lack of availability of 50ml syringes and the vague notion of how much fluids could stabilise Max at home means that in my vet's practice it's probably not that many clients who are doing sub cuts at home. Perhaps London is like that, people just don't have time or think they don't. The syringe method is so much easier and quicker than the giving set method. The whole thing takes us 5 minutes.

Max is now on 150mls a day, given in 3 doses when it's absorbed. He had a good night, ate Applaws at 2.30am (I now have 2 noctural eaters

) and then again at 6.30 and finished the little can after his 75mls this morning, which was quite quickly absorbed again. He is peeing more often at present too. I have no idea how long this is sustainable for or even if it's good for him, but nothing is worse than leaving him without fluids and just seeing him unhappy. This morning he purred away and had a little bat at his catnip banana. It's not even a week since he left hospital of course and I am realistic about everything.

Btw I read on Tanya's CRF site that lactated ringers sting less maybe than saline so we switched from saline to Hartmann's 11 solution (saline, potassium, lactic acid...I think). Has anyone else who did sub cuts used this one instead? I hope it is ok to use so much of it rather than the straight saline.

Mark · « **Reply #412 on:** June 18, 2009, 19:00:16 PM »

Good luck Kate & Max

clarenmax · « **Reply #411 on:** June 18, 2009, 18:50:49 PM »

Hi Kate, just topping up with some more

for you and Max

Bazsmum · « **Reply #410 on:** June 18, 2009, 17:53:19 PM »

swampmaxmum · « **Reply #409 on:** June 18, 2009, 09:42:30 AM »

I am just going to take it day by day and give him more fluids - it's up to 150mls, I give it 3x a day as he doesn' t mind and I'm getting better at it with the syringe (easier than the giving set by miles). This morning he didn't flinch at the needle and purred at the massage he got. Then he ate a little and I saw him in the passage batting a paw at something that had fallen on the ground.

I would not consider constant hospitalisation. I would consider occasional or intermittent if he had most of his time at home and feeling well. I am not going to decide that yet. I am really tired as the stress makes it hard to sleep even when the boys are themselves sleeping.

Desley (booktigger) · « **Reply #408 on:** June 18, 2009, 08:17:39 AM »

I am sorry his values are rising again, but I wouldnt put him on a diet or keep putting him on a drip in the hospital, I think this is a quality over quantity, both those will give him the quantity, but they will impact on his quality of life, he might get an extra year but he will be unhappy cos his food is restricted and you might not see as much of him as he will be at the vets so much on a drip, and if the diet doesnt slow things down, you will feel even worse at putting him through the stress for nothing, and ultimately CRF isn't cureable, only manageable, and there is only so much we can do for them - plus the stress of constantly going to the vets and having his food restricted might speed things up anyway. I agree it is easier when they look ill though.

Bazsmum · « **Reply #407 on:** June 17, 2009, 18:29:18 PM »

Beautiful pictures of a beautiful boy!

Maddiesmum · « **Reply #406 on:** June 17, 2009, 17:11:41 PM »

Bless him Kate he is beautiful

swampmaxmum · « **Reply #405 on:** June 17, 2009, 17:00:13 PM »

just one more, from before he was ill. The only diff you can see is that he is much less white around the muzzle, but he's not lost weight and his coat is still very good. I think it is definitely easier when they "look ill" if you know what I mean.

clarenmax · « **Reply #404 on:** June 17, 2009, 16:50:07 PM »

Awww bless him

I always think its really hard to accept they have health problems, when they always look happy and healthy

swampmaxmum · « **Reply #403 on:** June 17, 2009, 16:30:13 PM »

just a few recent photos, mostly taken with my mobile so not great quality but I love them all the same

this one taken in hospital. Some kind person let Max use her cat's bed while in there

then at home a short while ago in his favourite spot (where he hopes in vain for sun!)

and where he launched a vicious and unprovoked attack on his mum's finger when she ticked his nose
we call this game "piranha" and he's played it with me since he was a teeny kitten

Gillian Harvey · « **Reply #402 on:** June 17, 2009, 14:12:16 PM »

Sorry to hear those numbers have risen so high again, I think the IV fluids at the vets a pretty much constant so are supporting the kidneys much more than with sub cuts where that 100ml a day just isnt sufficient to sustain them. This is how it got with my Suzie, she had IV fluids at the vets and came home with me doing sub cuts, but there came a point with her that sub cuts just werent enough. I chose not to take her back for IV fluids because she had PKD and nothing in the world was really going to make that much of a difference ultimately, due to the quantity and size of the cysts, and also I couldnt face bringing her home and having her go downhill again.

I'm so sorry about your two sick boys, it must be hard to know which way to turn.

sheryl · « **Reply #401 on:** June 17, 2009, 14:04:42 PM »

Oh sweetie, no one should have to endure what you and your lovely boys are going through - it is so unfair and you must be exhausted.

take care of yourself xxx

Sending love, huggles and positive vibes for both of your lovely boys xxx

Daisymac · « **Reply #400 on:** June 17, 2009, 13:21:06 PM »

Just ditto all the love and good vibes on her and a big

swampmaxmum · « **Reply #399 on:** June 17, 2009, 12:46:01 PM »

Vet is due tomorrow to see Swampy's eye. I must pin him down on how much hope the weight loss option may give Max. The vet's very good, but he tends to change his mind from one day to the next sometimes on advice.
He said the problem is we are also possibly in a situation that he's not seen too often, in that he doesn't have any other clients who are prepared to nurse their cats 24/7 to maintain quality of life. He said most people would just wait for Max to feel ill and with the high numbers and his age (15 1/2) would pts.
I must TRY to be calm tomorrow and not just deal with Swampy's troubles - which he now thinks could go on for a month or two but the drops must only be every other day as otherwise they will cause problems - but get a proper discussion with him face to face about our options, if there really are any. I must also treat Max as he is feeling each day on sub cuts, not just the numbers I know, but I can only nurse him if he has quality of life. Today he does.

Maddiesmum · « **Reply #398 on:** June 17, 2009, 12:33:43 PM »

What a terrible situation Kate. I suppose the best you can hope for is the weight loss and the in and out of hospital option if you think he will cope with it. My thoughts and love are with you. I know you will do whatever is best for your lovely little boy

swampmaxmum · « **Reply #397 on:** June 17, 2009, 12:22:52 PM »

there just seems no hope. I am trying not to cry as he went to hide under the bed, but I can't not. The vet can't explain why Max does so well in hospital but deteriorates so rapidly on sub cut fluids.

Bazsmum · « **Reply #396 on:** June 17, 2009, 12:02:23 PM »

Im glad that Max is feeling well at the moment but how heart wrenching to know that giving him extra food when he is obviously hungry will assist in his decline!

More positive vibes for you and your brave men....

swampmaxmum · « **Reply #395 on:** June 17, 2009, 11:57:33 AM »

Max's creatinine has gone up from 386 on Friday in hospital on a drip to 459 today with sub cuts. The vet says it looks like he may have a week or less and then we have to decide if we put him back in hospital on a drip or not. The only doubt is he keeps saying that if Max could lose some muscle mass or weight in 2 - 3 months, then he may stabilise on sub cuts. So there's a theory about possibly supporting his kidney function with IV for 2 months, in and out of hospital and then he may live for up to a year. I don't understand why he does so well on IV fluids but we are losing him at home on sub cuts. But I'm doing 75 - 100mls twice a day now at home, up from 50. At his current levels he feels well and is playing and active, but once he gets to about 600 (in house: lab 500) he is clearly feeling ill.
Max ate well when he got back but is now miaowing for food but I'm not allowed to feed him until later on as over feeding will accelerate his decline. I don't have to tell you I just feel desperate.

swampmaxmum · « **Reply #394 on:** June 17, 2009, 10:19:55 AM »

I didn't actually have an appointment it seems. I just arrived and they took Max off for his bloods. I will speak to the vet later on this afternoon about it all. The nurse said they took enough blood to send to the lab too if necessary.

Desley (booktigger) · « **Reply #393 on:** June 17, 2009, 07:25:17 AM »

Good luck for his bloods

Sue P (Paddysmum) · « **Reply #392 on:** June 17, 2009, 07:09:03 AM »

Annoying about the syringes Kate, but glad that you've found the way the nurse showed you to be a bit easier. i still think you have the heart of a lion to do this.

Sheli_80 · « **Reply #391 on:** June 17, 2009, 00:45:06 AM »

Poor Max, hope everything goes well tomorrow will be thinking of you and sending positive vibes.

Author Topic: RIP baby Max: PLEASE READ UPDATE THREAD (Read 97204 times)