Chronic Renal Failure :(

[Gill (sneakiefeline)]

if Hamish and Misty are close then yes I think it would be best for her to see him.

I can understand everything you say about the past and I still think about it evn though Kocka went to the Bridge 2 yrs ago.

I would see what your vet has to say but he cannot go on not eating cos that will cause other problems.

I feel so much for you and I am sure that everyone else does too.

Please give Hamish a gentle stroke from me and my Gang of 4, I am thinking about you both 

[Stuart]

Hamish just managed to get up this morning, he had a drink" not a big one " Used his litter tray for a wee. and proceeded to head for his
route to get up on the window sill, via the tv stand and tv, but he is really unsteady on his feet, I lifted him onto window sill, and stood
with him, till he decided it was time to come down. I tried to give him some more Beef, He managed a very small piece, but went back
to spitting out the rest and then just looking at it.. I tried him with eggs 2 days ago, but wouldn't touch them..
the vet didn't tell me, and I didn't ask if he had ulsers or just bad teeth, she did show me his gums, and they were pretty discoloured
and red. Ill ask her tomorrow..
I have also been thinking that if his mouth was ok would he be fairing better??, HE Does want to eat, But I think the pain is stopping him
same goes for the drinking, he has had about 5 drinks today, but it is hard to see how much he is taking in, as he is not drinking normally
He just sticks his tounge out not even half way, and there is a lot of dribbling, then he just goes back to his pillow and lie's with his head
down. It Broke my heart today, when I was Clapping him, he Lifted his leg so I could rub his belly, He always Loved that. But I have been
Handling him as though he is made of Glass, So the rubbed Belly was a short gentle one.
I did think about the Syringe feeding but with his mouth being so sore, I dont want to hurt him, he has never liked his chin touched.
Hamish was supposed to go back to the vets tomorrow, But I think I will get the vet to come here, and we'll see what she is saying..
I have been thinking about the Past a lot today, I've had Hamish since I was 21, and in the bad times!! He's Always been there for me..
Breakups with girlfriends, Loss of Grandparents and family, when I've been unwell. etc.. He was always there to Comfort me..
Now I find Myself with this Decision " of being without him " I can Feel The Depression setting in. I know I Will still have Misty to help me
through this, But then That is another thing If The Worst Comes to the Worst " Do I show Hamish to Misty ??" I have been looking on
the internet to see what is best, and all I have found is that it is up to yourself (doesn't help much) I also read that some companions
also mourn the loss and stop eating. MY gut Feeling is NOT to let Misty see Hamish.
And I feel a bit pressured into making a decision about Hamish, because of work, they still haven't phoned me, but I got an e-mail yesterday
and basically I'm just waiting for the call to go. If I go Who will Look after Hamish??, and I know I would not be able to concentrate on
the Job IF I did go. the way I feel just now is to tell them to stick thier job...

Stuart..

[Elaine]

It wouldnt have done him any harm Mark, he just wouldnt have got the full benefit of vitamins.

[Mark]

Thanks Elaine,

I won't be giving him that again. It was  when I was at my wits end and he hadn't eaten for days
 - before he had the steroid jab.

[Elaine]

http://www.felinecrf.org/persuading_cat_to_eat.htm#eggs
Raw egg contains avidin,avidin combines with the biotin and makes it unavailable to the cat, since crf cats need their B vits, it is better to cook the egg white to destroy the avidin.

[Mark]

I was reading up on eggs and it said that most of the goodness is in the yolk, also that uncooked it has 80% higher absorbtion rate than cooked. I gave clapton some whisked raw egg when his mouth was bad.

[Elaine]

Hi Stuart, I know you have alot of serious things to think about at the moment as to Hamish and his future but I was wondering, is his mouth pain due to a bad tooth or is it mouth ulcers?  If it's the latter then slippery elm bark may help.
Hills AD isnt ideal for crf cats but at this point he must eat and it is very good for syringe feeding.  Maybe some cooked(not raw) egg white might be easier for him to chew and swallow.
I sincerely wish you both all the very best. xxx

[Desley (booktigger)]

Will be thinking of you and Hamish today, it sadly isn't sounding too good, I would try and have a serious chat with your vet about all the options, it does sound like his mouth is one of the biggest issues. At least he has an owner who is willing to put him first, and will do the right thing, that really will make all the difference.

[Bazsmum]

> Stuart....thinking of you and Hamish at this difficult time 

[Gill (sneakiefeline)]

Yes Mark thats the problem I reckon 

[Mark]

I dont know how cats feel mouth pain but in humans some cannot be touched by painkillers!

Metacam worked on clapton but maybe it doesn't work so well with ulcers?

[cheekee_munkee]

I guess I have been lucky with my blender. I used Iams senior and added phosphate binders and about 5mls water The Iams is in gravy and I didnt see any little bits in it. I'm guessing some foods contain ash and other bitty things.

Tiffy's mouth was really sore with the uraemic ulcers.

But using syringe feeding to get him hydrated they got better quickly and he tolerated the feeding.

[Gill (sneakiefeline)]

I dont know how cats feel mouth pain but in humans some cannot be touched by painkillers!

[Mark]

If he was given a painkiling injection (Metacam?) today, surely it can't be mouth pain bothering him? - maybe nausea? - poor Hamish 

[Gill (sneakiefeline)]

I tried putting food in the blender for Kocka who also had a sore mouth and the blender cannot make the food into a paste without little bits in it, like coffee grains, and that hurt her mouth badly cos it sticks in all the places its sore and she would not eat it. It caused her to be in pain.

Ad diet is grain free and like a cream, also very tasty but you have to get it from the vets. Kocka would lick it off my finger and also off a spoon and it was her main food for 4 yrs approx.

The problem is hamish cannot eat cos his mouth is too sore, cos he cant eat and is not drinking.........it maybe too sore for that too......he will be come dehydrated very quickly.

Stuart, I feel you have made a decision and my thoughts are with you 

[cheekee_munkee]

Sounds like the dehydration is making him feel lousy. I know its hard but please see if you can try sryinge feeding.

I know it will look like he hates it, but it could maybe turn things around. Ask your vet for a 20ml syringe

Get some wet food and your blender. Put the wet food in, add some water and puree.

Get a large towel, some kitchen wipes and the food in a bowl.

Get kitty and wrap him up in the towel. lay him down so his head is furthest away and looking up.

Take the plunger out of the syringe and spoon the puree in.

When full, hold the syringe so the plunger is facing away from you and shake it.  then draw up the plungers o the feed travels to the tip and the syringe is primed.

Use your non dominant hand and gently place over his head so you can control his head movement.

hold the syringe and place the tip in th cats mouth to the side pointing slightly upwards. The cat will automatically start to open and close their mouth and the swallow process will be activated. Slowly squirt a few mls aimed at the roof of the mouth. and allow the cat to swallow. Squirting and coating the roof of the mouth helps the cat avoid aspiration (food going into lungs). When sure the cat is ready repeat.

The puree needs to be thick enough to coat the roof of the mouth but not too think as to be difficult to give via syringe. The speed of the puree is important. The thicker the fluid, the slower the speed of that fluid and the easier it is to control.

I know this sounds cruel, but it could make all the difference. I did this wth Tiffy and I thought he was at deaths door. After about 3 days I saw a good improvement. I hope you might see similar things. Please think about it.

I wish you all the best and hope and prayers to kitty

[Stuart]

Hi PPL, I can't thank you all enough for your help and support through Hamish's time in need.
I got Hamish some Aberdeen Angus Beef from the Butchers ( that was hard cause I'm a Vegetarian ) nothing but pure beef, got my
mother to cook it, cut it up into little pieces for him, He went Mad for it, so enthusiastic until I noticed he was spitting it out. his mouth
is that sore he cant even chew now. I put it in the blender for him adding some water " he looked at it but wont go near it "
I have also tried him with the rest of the other cat foods, but the same again he just looks at it...
every half hour I wake him and sit with him trying to encourage him to drink, he is hardly sticking his tounge out, and is taking in
very little water, about 4 days ago I raised his bowl so he didn't have to bend down, but even that is'nt helping much now..
I still Cant Believe Only 7 days ago, Hamish was reasonably well, apart from not eating a lot and drinking more, even the vet said
today that his coat is still in good condition. But like a lot of you have said, I Know Hamish better than anyone. and I can see he
Really is unwell.
I have been trying to weigh out the good from the bad today, asking myself questions..
what will his quality of life be? what will be his benefits if he carrys on? do I really want to put him through this ?? etc.etc
He is an old Mannie, and although he was good with his sub-q injection, I could see he didn't like it as it was sore/uncomfortable
   I remember my mothers dog, she was 17 years old, she was still healthy but the body was done. I remember the conversation
I had with mum about putting her to sleep, but she was in denial ( I think we all go through that ) Her argument was that she
wasn't suffering as she was in no pain... but for six months I had to carry her outside to the toilet as she could hardly walk and
was semi blind and deaf. some people think there is only suffering in Pain,, but I also think if they cannot continue as they did
before, then that also is a form of suffering....

I can't think of anything more to say now, Hamish is in God's hand's
I Really Hope somehow he pull's through this and has some quality of life, But I also feel it may be his time:(

Thank you All again for your support, I HAVE REALLY Appreciated it..

I will let you know what happens...

KIndest Regards Stuart.............

[Gill (sneakiefeline)]

So sorry that Hamish is not improving 

I think if his mouth is so painful its gonna be hard for him to eat and am pretty sure that this is the main deterent for him right now. I have no experience of sub Q except what I have read from the wonderful people on here.

If he can eat wafer thin ham, let him, I would let him eat anything he can manage cos at least that will let him feel a bit better and any food is better than none.

Right now the effects of the food are the least of the worries I think.

Sending you and Hamish all my thoughts 

[Elaine]

Oh Stuart, I am so sorry to be reading this, I had hoped Hamish would have been in better fettle today.
Sadly only you can make the decision as to whether to continue with fluids etc.  Its a very difficult time I know.  Perhaps more fluids will help and perhaps Hamish may lose them as quickly again.
My only advice at this time is that you know Hamish better than any one so trust your instincts.
Maybe you could call another vet like the one in Mintlaw just to seek a second opinion about his condition before making a decision.
I wish both you and Hamish lots of love and best wishes, give the old fella a cuddle for me please.
Elaine xxx

[tammy]

I personally would not wait for the vet to advise. My cat had end stage cancer of the kidneys with tumors in all sorts of places and the vet was still suggesting doing stuff, which would have prolonged her life but not improved it-just prolonged the pain and stress. At that point she was struggling to swollow her own saliva due to tumors! My personal opinion if it were my cat would be that if she hasnt consistently good quality of life(and I dont mean just ocassional bad days are not allowed!) than its time to let go as hard as that may be-Ive lived through some hard times with my 2 and I can see it from both perspectives. You dont really want them to detiriorate too badly before deciding because thats what I did and it still haunts me to this day that the last few weeks of her life had been like that. Sorry to be glum but it will one day come for you to make this choice........... 

[Mark]

The words "emotional rollercoaster" often come to mind. Its almost like a full time job sometimes trying to make them eat and wondering if they should be at the vets again. I know Claptons numbers are much lower than Hamish' but we have been through similar things with him. He was refusing to eat at one point but the steroid jab kick-started his appetite. It has never been the same but he eats now. He had a bad tooth a few months ago but the vet said he couldn't risk anaesthetic and gave him antibiotics and vitamins.  Last week his teeth were so bad, the vet took his last 4 out.

Not all ham has phosphates but most processed meats seem to have them. I bought some Herta ham at the weekend as I saw it doesn't have them but I just looked at the pack again and it has onion in so I can't give it to him.

We have decided that if he loses quality of life we will make the decision. The thing is, they can bounce back so many times so there really never is a right time. Maybe it is something for the vet to advise on really. Its so hard to know what to do for the best.

[Gillian Harvey]

Hi Stuart,
I wanted to do subqs at home, but I found it quite nerve-wracking doing it for the first time on my own (even though I'd done it perfectly well while under the eagle eye of my vet first!) and I made a few mistakes, but to see how well Suzie did, after each injection, made all the anxiety worth it.

If your vet does think that nothing further can be done, you can ask that he comes to the house to pts, rather than stressing Hamish out by taking him to the surgery.

[Stuart]

Hi Mark

I'm sure any food is better than none but most wafer thin ham has a lot of phosphorus (phosphate preservatives) so would try to limit the amount. My cat willow seemed to know when clapton was feeling poorly and stopped bullying him. She is back to being a brat 
As for letting nature take its course, I would take the vets advice on that as I don't think its a good way to go (I think they have convulsions at the end) and it would be kinder for the vet to help him over if you make the decision. There is some info on the CRF site.

Ham Has Phosphorus ?? I cant win
I did read through my post a couple of times before submitting, and did wonder about the wording of (letting nature take its course)
what I meant was ... I still cant find a right way of putting it !! " If its not meant to be, and Hamish Loses his will to fight this, The time
will come for a decision to be made of being pts by the vet "
There is no way I would let him go by himself!!!, Like I said I dont want him to suffer..
16 years he's been at my side and I'm not taking this very well at all... in the past I have been there when the vet has pts family pets
and I do know it is a quick and painless esacape from suffering ..

[Mark]

I'm sure any food is better than none but most wafer thin ham has a lot of phosphorus (phosphate preservatives) so would try to limit the amount. My cat willow seemed to know when clapton was feeling poorly and stopped bullying him. She is back to being a brat 
As for letting nature take its course, I would take the vets advice on that as I don't think its a good way to go (I think they have convulsions at the end) and it would be kinder for the vet to help him over if you make the decision. There is some info on the CRF site.

[Stuart]

Hi Gillian, I was shown the way to give sub-q fluids, but I'm not keen on doing it (I'm hoping he will manage on his own) although it doesnt
look like he will. It would only take me 5min's to the vet if I change my mind. more IV treatment was suggested, but selfishly I said I want
him to be home in Familiar surrounding's. and not let the old guy get stressed out.. I Honestly Don't know what to do for the best...
I don't Like seeing him like this, and I don't want him to suffer..
I have got him wafer thin ham, and he has eaten quite a lot of that, But his mouth is really hurting him now even when he's trying to drink
the pain Killer should be working now ??

Misty my other cat (I have been neglecting him through all this) has been keeping his distance from Hamish, and just appearing now and
then to see whats happening and what all the fuss is about, It's strange but I think he knows Hamish is very unwell, and stares at him
when he's trying to eat/drink. although for a short period this afternoon ( long enough to get a photo anyway ) they were kind of back
to normal " minus the routine cleaning act " and slept together for a wee while..

But the way he is just now I am thinking of accepting the situation and let nature take it's course..it feels as if were fighting a losing battle
Keeping my Fingers Crossed for a Miracle that Hamish will put up a fight
Stuart.......

[Gillian Harvey]

I have to take Hamish back to the surgery on wednesday, the vet gave him sub-q injection and a painkiller injection for his mouth
He has lost all his IV fluids that he had done. I have also have Homeopathic drops to give him for his kidneys and veter gesic painkiller
for his mouth tomorrow. The vet says we are trying to stablize his condition, so he can manage on his own, But its not looking good

I'm sorry he's not doing so good. Is your vet going to show you how to do subq fluids at home? It doesnt sound as though Hamish will be able to manage on his own, since he's already lost all the IV fluids, he will quickly become dehyrated again, if he isnt already, unless he has further fluids at home, or is given further IV fluids at the vets. IV fluids at the vets will make him feel better again, but this will really need to be topped up by Subqs as soon as he is home. When my Suzie was on a IV drip for 3 days, I was told to start the subq fluids at home the day after she came home to keep it topped up. This only gave me an extra month with her - but right up until the last couple of days, she was doing really well, eating fine and acting normally - so she did have quality of life for that short time.

[Stuart]

I have to take Hamish back to the surgery on wednesday, the vet gave him sub-q injection and a painkiller injection for his mouth
He has lost all his IV fluids that he had done. I have also have Homeopathic drops to give him for his kidneys and veter gesic painkiller
for his mouth tomorrow. The vet says we are trying to stablize his condition, so he can manage on his own, But its not looking good

Hamish is back in the spare room, "but not under the Duvet" he hasn't drank anything yet or eaten, but the vet did say the
painkiller may make him sleepy.

Hi Mark, It's a catch 22, they cant risk sorting his teeth because the anesthetic would probably kill him, don't think its because
of his Kidneys, more to do with his thyroid and heart rate...

Stuart.......

P.S. Thanks for the tip about the Rescue Remedy Elaine, It seems to have worked a treat.

[Mark]

Sorry Stuart,

Is the reason they won't take the teeth out because they don't want to risk anaesthia with his kidneys?

Maybe they can give him some pain relief for his mouth and antibiotics.

Lets just hope the vet can suggest something positive.

[Tiggy's Mum]

Sorry to hear this Stuart    Hope the vet has some more positive news.

[Stuart]

Bad news, Hamish is not looking well today. His skin seems tight and his face is drawn, he is distant and didn't look at me
when I spoke to him. he has had his breakfast, but I am noticing that he is whinceing when he is eating, and he keeps
rubbing his jaw after food and water. His gum infection must be causing him pain.. I have been in Denial since his change
started. I work offshore, and have been on stand-by for the last 6 weeks. I am Lucky I have been home with him all
this time, and I think thats how I really noticed the change in him over the past few weeks..
My main worry now is that my work will phone me and send me off to a job ( I could be away for up to 3 weeks) and
I wouldn't be there to look after him. my wifes a nurse and she works 12hr shifts, which is no use iether....
I Feel the End is Close..It's just a matter of time.....
He has the vet's this morning, so we'll see what she's saying about him....I Dont see the point of trying to get him to
eat the medicated food, and I will buy all his Favorites for him today..

Stuart.........

[Desley (booktigger)]

I hope your vet just meant not fresh meat/seafood and not no meat/fish of any kind including cat food, as you will put his health at risk by not feeding any meat at all - cats need the taurine found in it, they can't make it themselves - and they can't live on a purely fish diet for the same reason, as fish doesn't contain large amounts of taurine.

[Mark]

I'm surprised at the "No Fish" advice. My vet advised fish and chicken for clapton. He said no Pork as the molecules are too large to pass through a cat's capillaries. It seems clapton won't touch anything made by Purina - ie Felix, gourmet pearl. If you haven't tried it, Whiskas senior in gravy seems to go down quite well. I know the phosphate levels are lower than regular whiskas as Masteroods gave me the numbers over the phone - Helen (Tiggysmum) passed the info on the the woman who runs the CRF site as they wouldn't give her the figures previously. Not sure if they are on the site now. Whiskas also do a supermeat senior but Clapton wasn't impressed with it 

I remember years ago before prescription and senior foods were available, vets always recommended fish for cats with kidney problems. If you haven't tried Hill's k/d chunks in gravy, PM your address and I can post you a couple for him to try. Clapton turned his nose up at them. I also have a dutch brand that he wouldn't eat.

[Gill (sneakiefeline)]

I am surprised that vet said no fish or meat cos surley thats what a cats food is,,,,,,,,,,,,,,,,,was this just real fish or meat or cat food?

Kocka had CRF and lived on ad diet and what ever else I could get her to eat, this changed often especially when I had bought a large quantity of her current favorite. She would only eat the ad from my finger and I now hate the smell of it!

She was a terribly faddy eater and thats why ad became her main food but she liked tescoes and sainsburys pouches............well she ate the jelly only!! She started eating supermeat again just before she passed to the Bridge and that was a last hope at getting her to eat at all and I was shocked that after so many years she would eat it again.

My vet told me its better that they eat something rather than nothing and because Kocka could not be medicated he said if it was his cat he would let her eat anything she wanted. She went to the Bridge aged 20yrs and had been ill for about 3-4 yrs.

[Stuart]

Yes Mark I have done the same in the past I remember i Used to buy them Felix in jelly, then Felix brought out the Gravy range,
thought I'd try them with that, they went off of that after a while, so I went back to Felix in jelly.
The wee butter wouldn't look at it so after picking every type of catfood off the shelf (like yourself Cheap/expensive) at the end of
last year they got a taste of Tesco chicken pouches, they loved them, I think it was about 4 and a half months ago, I noticed that there
was quite a lot of food left in their dishes?? so back to the drawing board i went, currently have Whiskas supermeat, Hi Life 60% real
poultry and Gourmet pearl sitting in the cat cupboard.
Hi Tammy, no I haven't tried the ocean range at asda, might give that a try also,

Try this link http://felinecrf.org/persuading_cat_to_eat.htm and if he won't eat the renal food, then just feed him his normal food, its more important he eats something.

I had a really good read at this, and it does say that you can give them normal food, but only for a short term
( although my vet said no chicken/fish or meat of any kind ) felinecrf.org Really is an excellent website !!!

my wife came home from work and went to bed, Hamish slept with her, It was 6 hrs later he appeared wanting food again !!!
He drank the bottled water, and he ate some of the pastry, but not a lot then he just Crawled his way back under the duvet, I
have been through with him to give him water, But when he's finished he just goes back under the duvet again

Hamish is back at the vet tomorrow, so we'll see what she says ..

Thank's for suggestions

[tammy]

have you tried the ocean range at asda? thats not its full name but I cant remember it. Its only seafood type stuff different stuff mixed togetehr and you can buy three portions for £1. It has a picture of a white cat on the front and you can buy sachets an tins. My Fluff had renal cancer and thats all she would eat near the end (I know its nowhere near the same as your prob but it may help!)

Good luck

[Mark]

I don't know if its just luck but I tried virtually every wet catfood I could find, including really expensive ones. After trying  expensive ones, I tried all the supermarket own brand foods. Clapton finally decided he liked Tesco own brand sachets in Jelly. I also try to get him to eat whiskas senior but 80 - 90% of his diet is Tesco pouches. I was worried about his blood readings being worse but they have improved so It can't be that bad. I tried all the renal foods but he won't touch any of them.

[Gillian Harvey]

Try this link http://felinecrf.org/persuading_cat_to_eat.htm and if he won't eat the renal food, then just feed him his normal food, its more important he eats something.

[Stuart]

Hamish is still looking bright. but at 2pm he appeared through in the kitchen where his food was kept (he has food and water next to him in
the spare room) he was hounding me for food, I opened a new sachet of the special renal food thinking he would eat that, he curled his
nose up a kept meowing looking at me, tearing at my heart strings, I gave in and tried mixing it with some boiled ham, No, he still wouldnt eat,
ended up putting small amount on top of food, and Cats being Cats, he just ate the ham.
I have also noticed his back end is looking unsteady and weak, I'm really starting to despair as I do not like seeing Him like this...
The vet says he can eat human stodgey foods, I know he likes the pastry off of Bakewell tart's, and some biscuits, and sometimes fried rice
from the chinese, but how can he survive off of that alone?? I have tried heating food in the Microwave "to no avail"

My eye's are going  with all this scouring on the internet, and I still cant find day any good suggestions!!

Has anybody any good suggestions ??

Thanks Mark, I'm away down to Lidls to get some bottled water, and a few packets of bakewell tarts....

[Gillian Harvey]

many times as you want, I also asked her about replenishing his fluid's at home, and she said this is done with a syringe under the loose skin at
the neck, sounds easy I see  sub-q's were mentioned, there was nothing said about those. what are sub-q's ??

p.s. I did ask about slippery elm bark and Phos Binders, but was told he  doesn't need them justnow

Yes, as Elaine mentioned, sub-qs are what your vet is talking about when he mentions replenishing his fluids at home. It would be better to start this now, because he will become dehydrated again quite quickly. Heres a link to a pictorial of how to administer (you need to scroll down a bit) - it really is easy. http://felinecrf.org/giving_sub-qs_syringe.htm

As to phosphate binders, if your vet's said he doesnt need them, then its likely his phosphorus levels are within normal range. Slippery elm is useful if he's feeling nauseous.

Glad to hear he's a bit brighter.

[Desley (booktigger)]

Am glad to hear he is home and seeming better, fingers crossed for him. Are they going to repeat the bloods?