Cat End Stage Kidney Disease in her final days

[sitti]

Hello,

Sorry this will probably be a long post with bad writing. I am quite upset right now...

I have a cat brought from the U.S. last year. She is now 15 years old (highly possible that she could be 2 years older. Can't say for sure she was homeless. Since she is a girl, I go by her youngest estimated age). I have had her for 14 years now. Couple months before we moved to Thailand, she was diagnosed of late stage CRF. Fortunately, US vet agreed to prepare and sign all required documents since she was healthy enough to fly. As advised by US vet, I started giving her subscription wet food, 100ml of fluid daily and Calcitriol twice a week. One week before departure, we did one more blood work to see if treatment is working. The numbers were lowered, so my US vet tells me to continue with this treatment. He also explained what to expect, what will happen, she may live up to additional 1 year and a half, this treatment is only temporary and no way to reverse this illness, and especially cat's quality of life. Then my cat safely arrived at Bangkok with us in August of last year.

Couple weeks after arrival, we took Meow (my cat's name btw) to Thai vet for check up and blood work. Result were almost no different from last blood work from the U.S., so Thai vet said this is the best she can get.

Fluid kept her happy and active for several months. Since Jan 2013, I began to notice her condition gradually worsen. She stopped grooming, less active, eat less, and losing weight. She already had problem with pooping and urinating outside of litter box while she was still in the U.S. but it was 50/50. But now she poops 100% and urinate outside of box more often. By April 2013, she became a lot weaker, no longer can jump from the floor to the desk. She barely can jump onto sofa and chair. And her fur falling off significantly a lot more than usual. She sleeps most of the time.

One of my worst days came on June 14, 2013 at night. When I came home I noticed she hasn't touched her food at all and drank only small amount of water. She vomited white foam several times. Deep inside, I knew what it was. But I refused to accept it and hoped that she probably ate bug or something and just upset her stomach. I went online and search around. I learned typical upset stomach usually goes away by next day. So I waited and see if she gets better. However, she didn't get any better in the morning. She looks weaker and won't eat at all. At this time I knew her time has come.

We immediately took her to vet. While waiting, I (31-year old guy) burst into tears like little girl. I knew I have to say good bye to her soon. Vet wants to keep her for several days for fluid therapy into a vein and tests. Later that day, vet called to inform us Meow's blood work was off the chart. They will continue with fluid therapy and see how it goes. 5 days later, her BUN was lowered by still very high. And her Creatinine got slightly higher from 4.4 to 4.5. Vet told me that she is at her final stage and her kidney is shutting down. She has a bit of time left. At best, she could have up to 6 months but unlikely. She won't get any better from this point, only worse. She still won't eat and vet has to force feed her by syringe. I saw she resisted hard with her remaining strength and spit out food. At that moment, I know what has to be done. That night, I called my US vet, and explained everything in detail. I asked him about "it". He said if I were in the US and requested him, he would gladly put her to sleep. Finally, I made the hard decision. I cried again.

On the day we brought her to Thai vet after Meow stopped eating, I had my mom asked vet about whether or not they will be willing to put her down when the time comes. (I am Thai, but from at age of 2, I spent my whole life abroad. We lived in Japan and US. I only can speak some Thai with bad accent). They said they would. But as I read at this forum about how Thai vets mostly refuse to put animal down due to Buddhism-way, my Thai vet became reluctant to put her down when we requested. All of sudden, they started saying Meow is improving, blah blah blah, she has a chance, and it is a sin. Her kidney is shutting down. She doesn't have much time left. They said so to my face. Anybody can tell that she is badly ill and not a happy cat. Most importantly, she refuses to eat. What the hell is improving!!! What chance she has!!! Soon the real suffering will start and have slow painful death. I will never make my Meow go through that.

I had my mom call vet. Explained how much I do not wish her to suffer, and wish to put her to sleep before her condition gets a lot worse. Also explained how people from Western nations see, feel, and think things differently. They said they want to keep Meow for 10 more days. If they can't get her to eat on her own, they will put her to sleep. We agreed. I am not so sure if they are really trying what the best for Meow but I'll just have to wait and see.

[jcgodber]

Very sorry to hear this and I am sad, Meow lived a very long time for a cat. I hope that the vet will put her to sleep.

I will say that I had a very bad thought. Perhaps the vet is reluctant to stop all his medical help because then he would stop getting a fee for service. As I say hopefully just a bad thought. I will be thinking about Meow and hope that she will rest in pease.

[Frogmountain]

I don't have any advice, but I wanted to tell you that I'm so sorry to hear about your cat's suffering.

[robblok]

I feel for you lost my dog the same way and I also could not find any vets that wanted to put her down. We did home care of the dog meaning we gave her the fluids and kept her happy here. The vet could not do more as we could and the dog was more comfortable at home. We gave her some xanax when she started to panic that helped. The last few days were horrible but in my opinion its better this as putting her at a vet that cant do more then you.

Good luck.

[bonobo]

Sorry you are going through this.

[catmac]

My thoughts are with you and Meow.

On a practical note, have you tried other vets to see if you can find one more in tune to Meow's needs and not their own beliefs. We are lucky in having a local vet who will end any of my pets suffering and pain when needed, but I know it can be a hard job finding the right vet.

At this dreadful time, take comfort from the fact that you have given Meow all the love and care that she needed when she found you 14 years ago.

Edited June 21, 2013 by catmac

[JetsetBkk]

Very sorry to hear this and I am sad, Meow lived a very long time for a cat. I hope that the vet will put her to sleep.

I will say that I had a very bad thought. Perhaps the vet is reluctant to stop all his medical help because then he would stop getting a fee for service. As I say hopefully just a bad thought. I will be thinking about Meow and hope that she will rest in pease.

I had the same thought. It's not bad, IMO.

I would take her to another vet immediately.

.

Edited June 21, 2013 by JetsetBkk

[Patsycat]

I just don't understand, having read so many threads on here about animals suffering, why vets will not make the difference between their religious beliefs and doing what is best for the animal.

Vets are supposed to be the doctors who help animals, not to let them suffer. And then the parents of the animals also suffer watching that.

I respect all religions, but find this just so barbaric.

Cuddle for Meow.

[ETatBKK]

very sorry to hear this sad story. my thoughts are with you and Meow in this difficult time.

perhaps you may consider to bring Meow home as your love and care may offer her a better comfort than in the vet. vet cannot do so much at this moment of time.

search a bit further in this forum or even ask if anyone has names of vets who could do the right thing.

anyone here if you have a vet that can do the job, please PM the OP as well !

[Sheryl]

So sorry to hear this.

I would agree that you should get her out of where she is as it is only going to be more frightening and upsetting to her.

This subject comes up a lot on this forum and sometimes people have had success by trying other vets. I would probably try a really upscale place like Thonglar Animal Hospital, bringing her records and making it clear from the outset that you are not going to agree to hospital treatment for her. They may be willing and able to at least prescribe sedatives to keep her comfortable so that she can die peacefully at home. Then take her home, put her in a lined box or other thing that is a bit womb-like so she feels hidden and secure, and talk softly and reassurringly to her. She will die more peacefully like that in her own home than in a hospital setting.

In terms of medications, in CRF it is not actual pain as such but rather discomfort and confusion/disorientation that are the problem so in my experience what works best is a sedative, or a pain killer that has sedating effects in cats (not all do).

Also sending you a PM

[sitti]

Thank you everybody for your kind words and information. I have brought her home yesterday. I too think there is no point of making her stay at vet. Currently, she is mostly laying down resting or sleeping calmly. After seeing her face at home, it is starting to make me much more difficult to put her to sleep. But I know it has to be done at one point. Thank you very much Sheryl for valuable info. At least now I can make Meow feel more comfortable when the time come. At this point, I don't think I want to put Meow in the car, drive around to other vets, and put more stress on her. But I will continue to ask around. When time is near, I'll take to her to some big expensive vet and hopefully may be willing to help better.

Before bringing her home, Vet did one more blood work. Her Creatinine went from 4.5 to 5.1.

I will try to enjoy the remaining time with her.

Edited June 25, 2013 by sitti

[Sheryl]

It doesn't necessarily have to be done if you can get appropriate medication to keep her comfortable.

[ETatBKK]

in the Veterinary Hospital of Kasetsart University, Bangkhen campus, ajarn Panchait ( รศ.สพ.ญ.พรรณจิฅฅ์นิลกําเเหง ) is a cat expert and she operates a CAT CLINIC ( a kind of ICU for cats ), on the 3rd floor of the hospital. call the hospital at +66 2942 8756-9 and confirm the clinic hour, and the registration process.

SITTI, bring Meow's medical history to her and you may get her advice on this case.

[Sheryl]

In this case there isn't any possibility of anyone being able to cure the cat. So unless this expert specializes in palliative care for dying pets (as opposed to "ICU" type care) it may not make sense. CRF is incurable and indeed is the most common cause of death in older cats.

The owner has made it clear s/he does not want to prolong the cat's life but rather ease her suffering and thereby lies the problem.

If anyone has had any experience with vets specializing in pain management, terminal care, palliative care etc please advise would be very useful and I will pin it.

[ETatBKK]

correct, this is the advice I meant from that senior ajarn - 'pain management, terminal care, palliative care etc . . .'

[farangme]

Very sorry to hear this. Lost two of my babies to the same problem years ago. Try to enjoy the time you have left together.

Sent from my PC36100 using Thaivisa Connect Thailand mobile app

[finnellypaul]

Hi There,

I hope this advise is not too late for you and your beloved cat

.

We run a shelter for cats here in Pattaya and use a vet hospital in Soi Khao noi, "Boonsamphan animal hospital" they are very sympathetic to cases of this kind, we recently had one of our cats put to sleep there after many months of feeding by hand etc.

I am sure if you take your cat there and bring all of the results of the recent blood tests with you they will help you, although they will probably want to have her in for a couple of days to observe for themselves.

We have another case here at the moment too, at the moment he still seems bright although has stopped eating by himself now so it is just a matter of time for him too, but we are comforted to know that when the time comes there will be no argument about helping him from his suffering.

Regards,

Paul and Sandra @ cats4youinpattaya