Help! Could this be the end??

Help! I discovered this site a few days ago, just in time for a crisis. I had to leave Silly (Drusilla) at the hospital today. She is 19 years old and was diagnosed with diabetes about 3 years ago. She has been in moderate kidney failure for about 8 months, and with mild kidney disease for a year or so before that. She had lost about 70-75% of kidney function by January of this year.

Over the past five days, everything has gone haywire. She has lost 2 lbs (down to 6 1/2 lbs. from 8 1/2 lbs.), is extremely dehydrated despite sub q fluids, had blood in her urine today, and her test results today were as follows: Phosphorus 9.6, BUN 114, Creatin 5.7 (doubled since last check in January). Strangely enough, her blood sugar has been normal for the last 5 days, although she hasn't had any insulin for the first time in 3 years. She has gone through three times in as many weeks of her monitor reading "Lo" & had to be given sugar to bring it back up. She's eating and drinking, although not enough.

She is now in Acute Kidney Failure. They are giving her iv fluids along with phosphorus binders overnight, and are going to let me know tomorrow afternoon if they are helping her kidney values. The vet has said that if this works in 24-36 hours, she may make a recovery, but if not, then we may need to consider putting her down. I can't do anything more for her until the results tomorrow, but need more input from someone else if I'm going to get any sleep tonight. I've had her since I brought her home in my pocket from the humane society, so obviously 19 years later, she's my baby. I am so torn that I may be faced with making a very hard decision for her over the next day or two.

Thank you for your response,

Shannon

I have taken the 911 icon off this post since Silly is no longer in critical condition. I would still appreciate any advice, suggestions, or comments as we nurse her back to health once she comes home tonight. Thanks!!

 

Shannon, this is heartbreaking. I can't give you any advice, but just wanted to say I am so sorry your baby is sick. It's hard having a cat so sick and away from you. You might want to post on GRIEF to get some advice on end of life decisions. ((SILLY))

 

Shannon-- I just wanted to let you know that I am thinking of you and your baby *hugs*

 

I am sorry that I have no advice to give you, but I wanted to let you know that you and your baby will be in my thoughts and my prayers.

~M

 

Deep sigh.

I'm no expert but I'll give you my two cents.

To answer your question … could this be the end? Sadly, maybe. The picture you paint doesn’t bode well, especially given her age, and I think you need to brace yourself to be prepared to make some difficult decisions.

That said, I wouldn't give up hope just yet. It’s not over until it’s over and sometimes they surprise us. Acute renal failure is rough stuff, but Silly is in the place she needs to be and is getting the treatment required in order to give her the best chance to bounce back. It’s out of your hands at the moment. And it’s okay to hang on to hope, even if it’s only a glimmer.

Kidney disease is 100% terminal …eventually. Sometimes through subQ fluids and pepcid and phosphorus binders, etc., we can delay the inevitable and give a decent quality of life, sometimes for quite a long time. However, at a certain point, despite our best and most heroic efforts, the body just gives out.

I’ve been through it with three of my cats. Heartbreaking as it is, they trust us implicitly and at a certain point, when it becomes obvious that we can’t “fix” them or effectively manage the disease any longer, then it’s time for us to take the pain onto ourselves in order to give them peace. Quality of life really does matter.

But for tonight, you don’t need to make any decisions, so try not to get too caught up in “what ifs”. Get some sleep and see what tomorrow brings. You’ll have a lot of answers in the next 24-48 hours and I think, in your heart, you’ll know whether it’s time. Hold out hope for the best, but prepare yourself for the worst.

My best to you both. Please come back and post and update when you know more.

 

Thank you everyone for your replies. Despite all her issues, Silly is one tough broad. She has come through episodes the vets thought she wouldn't, and she does it easily with a purr and a happy heart. Today was the first time that I had ever seen her act so defeated. I guess that's what scared me the most. She'll let me know when she's ready.

 

(((thinking & praying))) for you both.. please let us know as you have more information :YMHUG:

 

Paws and fingers crossed for your baby.

 

Adding prayers for strength and guidance.

thanks hope for correcting my typo

 

Yes she will definitely let you know when she is ready and then you can give her that last gift of life - peace and comfort and a safe cross to the bridge.

But until she let's you know, keep the good thoughts, we will too and hopefully she'll make it through.

Sending you lots of healing and soothing thoughts.

 

Silly did well through the night. They are pumping her full of fluids, and her heart is handling the extra volume just fine (a concern when hydrating an elderly cat too quickly.) The vet said she has perked up today (she's quite a spunky old lady!). She's still not eating much at all, but they're not too concerned about that at this point because the phosphate binders may take a while to clear out the build up in her kidneys that is affecting her appetite.

They will be doing more tests on her this afternoon to see if the medication and fluids are bringing her levels down. I should know more in a few hours.

Again, thank you for all of your support, caring, and prayers!!!

 

Paws crossed here for your baby.

 

I am so glad to hear that your baby is doing better! Her not eating still concerns me a little. If she doesn't start to eat soon, I would start pushing for syringe feeding or a feeding tube since not eating for more than 1 day can cause a whole other bout of issues for you both.

 

I got Silly's test results back and they are great progress, but not as good as the vet was hoping for:

Her phosphorous is back to normal at 5, down from 9.6 yesterday at this time.
BUN is 94, down from 114 (big improvement, but vet was hoping for more like 60's or 70's)
Creatin is 4.3, down from 5.7 Vet is hoping for under 4, but may not get there. (She was at 3.6 in January, and 3.0 last fall.)
USG is 1.018 (dilute). I don't know what yesterday's value was.
Her blood sugar is still fine, even with no insulin for 6 days (that baffles me to no end!)

On to their other reports:
She looks brighter and is much more alert than yesterday. (She looked pretty pathetic last night & had lost her sparkle.)
She has had over 600mL of IV fluids since last night, and some of it must be sticking b/c she has gained several ounces. The sub q fluids we had been giving her in smaller doses at home were going right through her as she continued to lose weight.
She is still not wanting to eat. They've given her many choices, but she is an extremely picky eater to start with, and of course she's not feeling so hot. She'll take a few bites, then lose interest. They have been syringe feeding her today just to get some protein and calories in her.
They are giving her Azodyl for internal diuresis. Apparently it binds to toxins so she poops them out & the kidneys don't have to work on them.
She is also getting aluminum hydroxide as a potassium binder.
I wrote in my notes that she's getting a supplement from Standard Process, but I didn't write down what it is for. Seems like she said something about natural herbs, but I'm not sure.

They are keeping her for another day and running the tests again at noon tomorrow. Keep the prayers flowing, and if anyone has any comments, advice, or suggestions for her, please let me know.

Thanks,

 

I am praying for a good outcome for your Silly, Shannon, please keep us updated. If she has pulled through before, she can do it again :YMHUG:

 

Silly is making a great recovery!! Her BUN is down to 76 (94 yesterday & 114 the day before), and Creatin is 4.1 (4.3 yesterday and 5.7 the day before). She is eating a little more, and accepting the additional food by syringe without much protest. She has had about a liter of iv fluids, so she is finally rehydrated. They are going to wean her off the iv fluids over the afternoon, and will be ready to come home tonight just before the vet closes. She will need lots of extra care and love over the next few days, and the vet and I agreed that she would rather have it in the comfort of home than staying there one more day.

Thank you so much to all of you. This has been an incredibly stressful week for me (and for Silly too!!), and I really appreciate all the love and encouragement I have received on this board. I don't know how freaked out I would have been while dealing with this if I hadn't found this board last week!!

All the photos I have tried say they're too big to add to my signature. I'm not sure if these will work, but I've attached a few photos of Silly. The first one was a few months ago, and the other is from 1992 when she was a kitten.

 

She is a most beautiful kitty, and I'm glad she is feeling better.
You are a good mom-bean.

 

Oh man, was that a kitten to fall for, or what?

I am so pleased to hear she is ready to come home. Stay well you Silly girl.

 

I am so glad Silly can come home tonight and is feeling better. We give Blackie Azodyl and have for the last year. I think I've heard of the Standard Process stuff - is it Renal Food? Have you joined a CRF yahoo group? There are several and they are a great source of information and support.

Sending Silly prayers and healing energies. I hope she can have a lot more QOL time with you.

 

That is wonderful news Shannon!!! I will keep you both in my prayers for her continued recovery. What a gorgeous, strong girl!

 

Silly is glad to be home, even if she did had to have a bath (cats just LOVE those!) as soon as she got home. I'm not happy that the vet let her get to be such a mess (she smelled all kinds of strange, plus had feces in the fur of her back legs), but on the other hand, they were able to bring my Silly Girl back around, so a bath is a much happier ending than we could have had this week! Once that ordeal was over, she allowed me to snuggle her for a very long time as I dried her off.

She is very tired and weak. It took her two rests along the way to go up the staircase she goes up & down all day long, but she is resting comfortably in her favorite spot, on her blanket in a corner of my closet. She wants no part of the a/d prescription food the vet sent home, but she likes the Friskies Turkey & Giblets that was recommended elsewhere on these boards. She was 7 lbs. 11 oz. today. That's great news since she had dropped 2 lbs. down to 6 1/2 lbs. before going in two days ago. She had already been given all her meds today, so we start that fun tomorrow. Can't wait to shove pills down her throat! She's been quiet, even during the car ride home, but purrs as soon as I start petting her. Miss Drusilla J. is one tough cookie & she's not going to go out without a fight! dancing_cat

Here's a pic that I just took of her chillaxing in the closet.

 

Shannon, I'm so happy for you and Silly that she is home now, all cleaned and in her closet. What a beautiful old girl and what an adorable kitten she was. I'd have grabbed her in a minute......love those calico kitties. Sending good wishes for a lot more time with your very special girl.

 

Shannon, I'm so happy for you. Enjoy each and every additional day you have with Silly. And thanks for posting an update. I've been wondering...

 

Yay! Sooooooo happy for you!! Will you change your subject line so we (((I))) do not think there is a cat dying if I dont comment?