# To put to sleep, or not to put to sleep..?



## voxie (Jan 16, 2011)

I'm sure this is one of the most popular questions to come from all kinds of pet owners.

Basically, I found my cat to be losing a lot of weight, drinking more, eating less and seeming a bit "spaced out" most of the time. I took him to the vet yesterday and he was diagnosed with kidney disease. The blood test showed that his kidney's chemical levels are extremely high and passed the recommended limits. She stated his kidney disease is severe, and suggested having him put to sleep.

I cried my eyes out! I wasn't expecting his condition to be so bad, that he should be put down! Not one bit...!

They had added fluids to his body via drip, in order to take a blood sample from him (his blood was too thin at first). He was also very dehydrated and quite poorly.

On returning to him though, he seemed much perkier, answering his name, meowing at me and obviously wanted to come home! I told the vet that I would like to at least take him home to say goodbye before I have him put down. She said okay, and see how he gets on over the weekend.

The vet also found it strange that he hasn't been vomiting - the other usual symptom for kidney disease. She said he'll be okay for now, but he will deteriorate eventually. She recommended having him put to sleep now, before the suffering begins.

But since Lion (pr. Leon) has been home, he's been drinking lots (as before) as well as eating ALOT more (I'm guessing the vet's drip brought his appetite back?). He's walking about the house a little, and sleeping on our laps.

As I watch him eat his food like that, such a change from before he went to vet, I think to myself:

"He doesn't want to go. He wants to live."

So now I'm left with the decision. But if he's not giving up, then why should I?

I would like to put him on a renal food diet at least (I've seen some on ebay called Royal Canin - would anyone here know of them?).

The vet said she would have recommended a diet, however the results of his blood test were severe. But my cat's behaviour really contradicts that putting him to sleep is the best way to go!

My friend, who owns many dogs and cats, and has had a few euthanised before said to me: "Only you, the owner, will know if your pet is ready to go."

Anyway,I thought I'd share my story, to gain some opinion from those who have experienced the same, but mostly, to get it out of my system...

Thanks for reading, and any opinion is much appreciated


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## Kiwi (Nov 18, 2010)

I don't know anything about kidney disease I'm afraid. I'm sure others will help with that. I just wanted to send you a hug at this difficult time and to say I think your friend is right  you know your cat better than anyone. Many on here say better a day early than a day late but if you are watching closely, I think you will probably know. Thinking of you x


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## hobbs2004 (Mar 12, 2010)

Voxie, have a browse through this website and also join the forum: Tanya's Comprehensive Guide to Feline Chronic Renal Failure. What these ladies and gents don't know about kidney disease is not worth knowing. So read, read, read.

Shame you didn't get to a vet sooner when you first started noticing that he was drinking more, losing weight etc but what is done is done. A prescription diet is certainly one way to help control kidney issues and I am sure your vet will talk you through your other options depending on he does today.

All the best for you and your little man Voxie!


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## Doolally (Oct 12, 2010)

Unfortunately it will get worse, but there are drugs and diets to try to limit the pace of progression. And if he's happy at the moment then I don't see why he shouldn't be given a chance. He does need treatment though, without it he will deteriorate quickly.
Either go back to your vet and say you want to give him the best possible chance, or find another vet who isn't so pessimistic. Talk to them about diet, drugs, and whether you can give fluids under the skin at home to help him when he gets dehydrated.


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## voxie (Jan 16, 2011)

hobbs2004 said:


> Voxie, have a browse through this website and also join the forum: Tanya's Comprehensive Guide to Feline Chronic Renal Failure. What these ladies and gents don't know about kidney disease is not worth knowing. So read, read, read.


Many thanks for this link, hobbs2004!

Upon reading this page on How Bad is it?, I'm even more confident that putting Lion to sleep isn't the right decision at the moment. He was dehydrated on arrival, meaning his kidney levels weren't at their best condition for testing.

I'm going to get a copy of my cat's bloodtest results so I can compare them on Tanya's site. (Hopefully I won't have to pay another £150 to get this!)

Tanya suggests rehydrating your cat first. This will be my highest priority - I'm going to have him eat renal foods and drink as much water as he likes, then in a month's time, have him seen to again.

I will track his health here, just in case anyone can use this information.


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## bellathemog (Sep 30, 2010)

hobbs2004 said:


> Voxie, have a browse through this website and also join the forum: Tanya's Comprehensive Guide to Feline Chronic Renal Failure. What these ladies and gents don't know about kidney disease is not worth knowing. So read, read, read.
> 
> Shame you didn't get to a vet sooner when you first started noticing that he was drinking more, losing weight etc but what is done is done. A prescription diet is certainly one way to help control kidney issues and I am sure your vet will talk you through your other options depending on he does today.
> 
> All the best for you and your little man Voxie!


Yup agree.

My Bella has CRF and is HYPER. PLEASE DONT PUT YOUR CAT TO SLEEP!!!! if you love him then speak to your vet about various foods/meds that can help him. Yes he may just have a few weeks/months but he is worth that isn't he?

I was the same when I got told Bell had kidney problems, that wasn't the end of it she has high BP, over beating heart rate and is HYPER.

I'm doing EVERYTHING I can to help her along the road as I can.

She is infact back at the vets tomorrow for bloodwork.

Please dont give up there are people out there going through what you are.

Here is Bella ( SEE ALL TABBIES SHOULD STICK TOGETHER )


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## bellathemog (Sep 30, 2010)

Here is my kidney failed mog ( she sends her hugs)​ :thumbup:


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## BSH (Jul 28, 2010)

I am very sorry to hear your news about Lion.

CRF is an unrelenting process and once it becomes severe then sadly there is little that can be done for cats. You should certainly speak to your vet who will give an honest professional opinion.

He has improved after IV fluids and that is good but he will deteriorate again sadly. Once a mammal (be it cat or human) has severe renal failure the only effective treatments are dialysis or a renal transplant and obviously neither are an option in a cat.

When renal failure is mild or moderate other treatments such as diet and medications can help slow down disease progression & deterioration but sadly in Lions case this may be futile at this stage.

I have seen many people (and some animals) with end stage kidney disease. It is a horrible way to die and having your pet PTS is often the kindest thing. A very hard thing to decide to do, but the kindest (I have been there and it brings back painful memories).

So I would have a frank and honest chat with your vet tomorrow who should be able to give you clear information so you can make an informed decision regarding Lion. Do ask questions and if they are not clear in what they are saying, ask them to re-explain. Vets & doctors have a terrible habit of using medical jargon they assume everyone else understands.

My thoughts are with you both and I wish you the best in whatever you decide


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## Ianthi (Oct 21, 2008)

Hi there!

No, your cat does NOT sound as if he wants to go!

Sorry I missed this yesterday. Please do not be put off by your vet. Unforunately in UK this PTS is the response ( very needless in view of how many cats actually recover after a crash etc and with careful monitoring and dietary adjustments go on to live for years after diagnosis ) of most vets and frankly I find it amazing this is still the case. Considering your cat has improved after IV fluids this is a good sign!

I'm glad to see Hobbs has directed you to Tanya's site and please do join the Yahoo group mentioned as well.

Now and this is very important in view of your cats high initial numbers-has your vet tested for *kidney infection/stones*? Cats who have them present with very high numbers initially. These conditions can cause Acute Renal Failure as opposed to chronic and once they are under control renal levels can return to normal. Please ensure your vet *has ruled these out* first before you proceed any further and it doesn't sound to me as if this is the case! If, for example kidney infection is the cause a 4-6 week course of antibiotics is needed to eradicate it completely and Baytril is the best one for this!

Incidentally, there are vets out there who are more pro-active with ARF/CRF - it's only a matter of finding them!

Best of luck in finding a new vet!


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## voxie (Jan 16, 2011)

First of all, many thanks to everyone for all your comments. My heart is with you all and I hope you and your pets are getting on well also.

From last night to this morning, Lion's perked up condition from Saturday's vet visit did deteriorate slightly. He went back to sitting around in the meatloaf position with that slight daze in his eyes. But not as bad as _before _the vet visit. He interacts with me, answers his name... He just seems extremely lethargic. He does drink a lot, as before, and surprisingly, eating as well - Still not as much, but seeing as he's eating food, even when I haven't warmed it (this helped him eat his food before) is a good sign. Also, still peeing and pooing and no signs of vomiting (except in the cage when on the way to the vet, which I feel is travel sickness, as we travel by bus).

Of course, I know his kidney's condition won't improve from the damage already done. It's a terminal illness, and the only option we're left with is to put them down now or later. But as I watch him eat, drink, look and meow (albeit less) at me, I can't give up on him as long as the fight's still there in him.

I've returned from the vet just now - I got a different one seeing to Lion, as the one on Saturday (Stephanie) was a fill-in for someone off-sick.

Because of Lion's bad breath (a popular CRF symptom, due to the dehydration), the vet injected Lion with an anti-biotic to help make him feel better, and less groggy. He also gave an oral supplement to help with his appetite - which the vet described to me was actually an anti-depressant for humans! He said that one quarter of this happy pill helps a cat's appetite for around 3 days, which is interesting!

The vet also suggested leaving Lion there for a couple of days. The vet said he will pack Lion with fluids and make him happier (in his words "wash him out" and "until he pees his balls off!"). He did warn (as Stephanie did) that after doing this with many cats, they tend to deteriorate very quickly. However, he said there is a minority of cats that do come out feeling better. Also, he said, that even if he does come off for the worse, at least you can say you've given him the best chance.

And with that, I felt reassured. With him left with them, I can go to work without worrying to much.

Lion seemed comfortable in the vet room as well, sniffing and rubbing objects close to him! I hope he'll be okay in there without me. The vet suggested calling in around after 4pm, to see how he's doing, which I will do.

Thanks again for reading - I will track progress of Lion here in case anyone else may find it useful


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## Kiwi (Nov 18, 2010)

Fingers and paws crossed here Voxie x


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## Ianthi (Oct 21, 2008)

Hi there,

I'm glad to hear the vet has suggested keeping him on IV for a few days-you need this amount of time to ensure the best results really! This will help flush out the toxins and also make him feel a lot better. Also this vet sounds a bit more positive and pro-active which is essential. Sounds as if the appetite stimulant was Mirtazipine which is used as an anti-depressant in humans!

Actually how old is your cat? Don't forget to ask vet about ruling out kidney infection and stones though. With those very high numbers sounds very likely to me especially if he's younger though both can affect older cats as well!

The good news in your case is your cat is still eating and drinking well and it's always best to take the view of treating the cat and not the numbers.


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## voxie (Jan 16, 2011)

Ianthi said:


> Actually how old is your cat? Don't forget to ask vet about ruling out kidney infection and stones though. With those very high numbers sounds very likely to me especially if he's younger though both can affect older cats as well!
> 
> The good news in your case is your cat is still eating and drinking well and it's always best to take the view of treating the cat and not the numbers.


Hi Ianthi 

Lion is 12 years old this coming May - I will have to double check my diaries, but I believe I got him in 1999. I was literally a teenager back then and didn't keep track of anything! He's at the very most 13.

And kidney stones (thankfully) haven't been mentioned - I called the vet earlier today, and he said he would do a blood test on Lion later to get a reading on his kidney levels. I will get an update in the morning.

I really miss him - I keep thinking I hear the bell on his collar, here in the house - when it's just a zipper or glass!

And I totally agree with your last paragraph there Ianthi - Each cat (or any living thing for that matter) should be taken on an individual note, with numbers just as guidance! 

Thank you all again for your warm wishes and hugs - I hope your pets are well also xx


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## Ianthi (Oct 21, 2008)

Hi Voxie,

What I meant earlier was that infections and stones can cause renal numbers to be off the scale and once they are investigated and cleared up/removed then the kidney levels often return to those previously! An ultrasound is needed to ascertain the presence of stones though.

Trouble is that some vets don't always bear them in mind when renal failure occurs and automatically believe it's due to a chronic reason ie degenaration due to old age. Considering Lion's relatively young age and those very high numbers, infection could well be the cause and a ( long ) course of antibiotics would be all that's required! So do ask the vet about this!

Good luck with results tomorrow and keep us posted!


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## jomary-austin (Apr 9, 2009)

I do feel for you. CRF is a major rollercoaster, Tanyas feline CRF website has lots of useful info on and helped me last year. 

Our elderly Persian developed CRF and lived for another year after diagnosis, she was on fortekor and I fed her whatever she fancied eating and every now & then she went to the vets for rehydration and weighing. She initially gained weight on the fortekor and was really fine up until late May 2010 when she had something like a fit and she never really recovered from that, we finally had her PTS in mid June and it was the right time.

You will know when the time comes. If he has lots more bad days than good days then you need to think about it seriously as it is not only miserable for your cat but also really painful for you to witness your cat in decline. But while he's eating and enjoying contact with you he's fine, cat's don't think like us, there are know what ifs and if onlys, they live for the moment and accept things. Apparently CRF feels like a big hangover so isn't actually painful but not pleasant either. 

If you are having doubts about euthanasia now then it clearly isn't the right decision. You will definitely know when it is the right time to let him go and it isn't now.

Wishing you all the best.


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## CrystalGecko76 (Jan 19, 2011)

My cat Kitana also had liver problems but he had it for a good few years before it beat him. He also had thyroid problems too.

He once got taken in to the vets over christmas and put on a drip, when he came back he started to eat again and all was well for awhile. His regular check ups said that everything was borderline ok and there was nothing to worry about at that time. Then just before christmas he stopped eating and drinking and was sleeping all the time. If you tried to move him he would shake and wobble. It is really hard to see a cat go downhill like that. You may have a good few years ahead of you still but you will need to monitor him always and get regular vet checks.

My thoughts are with you as I know it is a very hard thing to witness and a hard choice to make but you and your cat will know when the right time is. 

Blessings,
Crystal xxx


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## Izzie999 (Nov 27, 2008)

voxie said:


> I'm sure this is one of the most popular questions to come from all kinds of pet owners.
> 
> Basically, I found my cat to be losing a lot of weight, drinking more, eating less and seeming a bit "spaced out" most of the time. I took him to the vet yesterday and he was diagnosed with kidney disease. The blood test showed that his kidney's chemical levels are extremely high and passed the recommended limits. She stated his kidney disease is severe, and suggested having him put to sleep.
> 
> ...


Hi,

Firstly I am so sorry you are going through this with your beloved cat. He is a gorgeous boy! Your friend is right,you will know when the right time has come,he will give you very clear indications he has had enough and you know him well enough to know it will be kinder at that point to do it then.

Enjoy him as much as possible,spoil him and enjoy your time with him.Perhaps arrange with your vet that he comes out to you to put him to sleep rather than having it done at the surgery. I would also ask your vet to administor a sedative which will make the procedure less traumatic for you and your boy,I was quite shocked at how quickly the animal dies after the injection and it makes it more upsetting really.

Izzie


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## colette85 (Jan 5, 2011)

im so very sorry 2 read about your beloved cat firstly

as a owner i think we have an understanding with our pets when its just time 2 let go if you get what i mean im sorry if im sounding hurtful or rude i am in noway trying 2 be either

also im right annoyed that the vets always say best 2 pts 

how on earth do they know? ok maybe they have the interest with owner as in money sense etc but thats damn well heartbreaking hearing those words in sure

speak 2 the vet on the condition of your cat as i dont know about this failure sorry 

i hope for the best for you n your cat x


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## colette85 (Jan 5, 2011)

Ianthi said:


> Hi Voxie,
> 
> What I meant earlier was that infections and stones can cause renal numbers to be off the scale and once they are investigated and cleared up/removed then the kidney levels often return to those previously! An ultrasound is needed to ascertain the presence of stones though.
> 
> ...


i hope this is somehow right i feel for the owner right now i just hope the vet checks 2 see if its an infection

if your reading this TW ask x


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## Amethyst (Jun 16, 2010)

Just wanted to send some good and positive thoughts for you both. has your vet considered allowing you to administer subcutaneous fluids at home? Not sure if this is still done, but maybe worth asking about?

All the best and much love to Lion x


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## Ianthi (Oct 21, 2008)

[QUOTEalso im right annoyed that the vets always say best 2 pts

how on earth do they know?[/QUOTE]

I agree completely! Ruling out the very obvious cases where it's the only course of action some vets initial response is to PTS without instigating any treatment at all! How will you know if you don't try? In the UK this is particularly true where CRF is concerned even in cases where diagnosis is made in the early stages!! I know in some instances the welfare of the animal is at the forefront of their thinking and they wish to prevent any further suffering, but I also believe in quite a number of cases it's a reflection of the competence level of a lot of vets regarding this condition in particular, hence this gloomy dismissive approach!

Frankly, I've lost count of the number of people who's original vet wanted to PTS who upon consulting elsewhere, the pets went on to live for many happy years! Vets are not infallible and it's always worth getting a second opinion!

In Voxie's case I'm particularly concerned the vet hasn't ruled out infection as a cause especially since the initial renal numbers were soo high-it should have been the first response to at least rule it out IMO!


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## colette85 (Jan 5, 2011)

Ianthi said:


> [QUOTEalso im right annoyed that the vets always say best 2 pts
> 
> how on earth do they know?


I agree completely! Ruling out the very obvious cases where it's the only course of action some vets initial response is to PTS without instigating any treatment at all! How will you know if you don't try? In the UK this is particularly true where CRF is concerned even in cases where diagnosis is made in the early stages!! I know in some instances the welfare of the animal is at the forefront of their thinking and they wish to prevent any further suffering, but I also believe in quite a number of cases it's a reflection of the competence level of a lot of vets regarding this condition in particular, hence this gloomy dismissive approach!

Frankly, I've lost count of the number of people who's original vet wanted to PTS who upon consulting elsewhere, the pets went on to live for many happy years! Vets are not infallible and it's always worth getting a second opinion!

In Voxie's case I'm particularly concerned the vet hasn't ruled out infection as a cause especially since the initial renal numbers were soo high-it should have been the first response to at least rule it out IMO![/QUOTE]

exactly  i know the vets have the interest of the animals but wouldnt you think that they would go make sure they have their facts completely right before suggestions 2 PTS? that word 2 me is so heart breaking 2 any owner whether you had that beloved pet for a few weeks, months, years!

with the post related 2 kidney failure n infections n numbers being high i know nothing about this but 2 be honest i believe you n have hope in this matter especially for the owner n her cat


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## colette85 (Jan 5, 2011)

oh my dunno what happened with my post all your msg didnt quote


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## voxie (Jan 16, 2011)

Hi everyone! 

Just to update...

*Wednesday 19th & Thursday 20th January*
Lion's condition had greatly improved! The fluids worked in washing all the toxins out. His kidney's Urea levels have dropped from an extremely high to a normal level, which is great! The other levels (Creatinine etc.) had also decreased but the figures are still beyond the normal scale - going down from the 600s to the 400s.

I had asked about *kidney stones* on Thursday. The vet said kidney stones is very rare in cats, and the chances of Lion having it is low. To be 100% they would have to do a scan, which would cost lots, and it's probably not worth it, as the chances are so low.

So kidney stones hasn't been ruled out completely! But following the vet's recommendation, I decided that I would see to Lion's condition when he comes home, and decide what to do following his progress on that.

Are kidney stones as rare in cats as this vet is saying, I wonder?

*Friday 21st January*
Lion happily returned home last night, after staying over at the vet's for 4 nights straight! Its been a tad surreal having those 4 days without him in the house for the first time. With the news of possibly haviing to be PTS earlier in the week, it felt almost like Lion had died, but hadn't really.

On first looking at him, he's put on weight! Being approx. 3kg when arriving at the vet on Monday, yesterday he weighed at almost 4kg, which is wonderful! The vet had been giving him antibiotics everyday, and he has been eating 3 times a day. Plus of course, he's been getting the IV fluids as well.

Lion has unfortunately developed bad teeth on the right side of his mouth. He has sore gums, and the lower may need to come out. The vet said this is possibly a tooth problem that went unseen before, but the kidney problem has elevated. He recommended that a tooth operation wouldn't be advisable at Lion's current stage. I'm very concerned about this, as it will only add to his eating troubles, with the lack of appetite re: the kidney disease.

Overall, Lion is in a healthier state compared to when I first posted here, which is great news. But from here on out, the fight is now with him.

To go home with, the vet has given me a blister pack of 10 antibiotic capsules (Antirobe 75mg) to feed Lion once a day. He at first said to feed it into the back of his throat, demonstrating it to me as I held Lion's front legs. He _really _struggles. The vet then recommended mixing it in his food instead! This antibiotic is to help his sore mouth and his overall state.

The vet has also give me one the happy pills I mentioned earlier (Mirtazapine 15mg), splitting the one pill into 4 quarters, to be given once every three days to help his appetite.

The vet also gave me lots of the Hills prescription diet in tins and sachets, which is what they've been feeding him there. Finally, the vet recommended Lion coming in for a check up mid-late next week.

On getting home, Lion seems bright, active and he even ran up the stairs to use his litter box - it really is a happy sight!

The vet had instructed me to give one happy pill tonight (and consecutively 3 days after). I mashed it into a powder between two tablespoons and mixed it with Hill's sachet food - he ate about a third and a half of it, happily, and lots of water.

The other third and a half was unfortunately thrown away by my stepdad, who had come home very late and given Lion something else to eat while we were asleep! :scared: It was normal Whiskas cat food. He has been warned of this now, and I've removed all normal food from the cupboards. It was only a small portion, so I hope it won't affect Lion's kidneys at all...

Does anyone know how dangerous normal food is to CRF cats? If it is not a full portion (thus not a whole lot of phosphorous to digest), can it still dangerous?

Lion had slept on me soundly for the evening... Happy & purring 

*Lion's state today:* Bouncy! Eating lots. 

*Saturday 22nd January*
Today so far, the only problem I have is getting Lion to consume his antibiotics. Mixing them in his food doesn't seem to work - I was wondering if it was because he'd had enough of the Hills tin food (which is very soft, like pate), so I tried it with the sachet (small chunks) version. No success, again! Two capsules wasted..!

We've tried dropping the capsule into the back of his throat, but it's just too distressing for him - he struggles and whines a lot. I gave up because I was finding it too upsetting.

I tried once more with a 4th capsule, mixing it which his classic fave, fried chicken from the takeaway (which someone had come home with). He has eaten a couple of bites, but he stopped there - the taste of these capsules is obviously horrid! I'm going to let him rest a little and try getting him to eat the rest later... Maybe hide it in warmed Hills sachet food?

His behaviour today has been lazier than yesterday, but walks and jumps about the house as normal.

His eating however, isn't as animated as it was last night. It must have something to do with the lack of antibiotic and appetite pill.

I'm worried, and not sure what to do. He's had _some _of the antibiotic and _some _of the appetite pill. I'm going to attempt at making him eat the rest of the antibiotic chicken from earlier now. And I might cut a half of one of the other appetite pills to feed him. I just fear wasting it all, he's a very fussy eater...!

*Lion's state today:* Lazy, purring, not eating as much as yesterday.

Will be monitoring him for the rest of the weekend & continue updating here. Thank you for reading - I hope some people find this useful xx


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## voxie (Jan 16, 2011)

Ianthi said:


> Hi Voxie,
> 
> What I meant earlier was that infections and stones can cause renal numbers to be off the scale and once they are investigated and cleared up/removed then the kidney levels often return to those previously! An ultrasound is needed to ascertain the presence of stones though.
> 
> ...


Hi there Ianthi,

I did ask, and the vet's reaction was sort of like,he didn't believe there was a chance it could be kidney stones. He also mentioned the bills would be high. Money really isn't an issue to me with this. If his condition doesn't improve by the next appointment (next Wed/Thurs), I may have to ask again.

Is there anyone out there who has had a cat with kidney stones? Kidney stones I imagine can be quite painful for cats - Is this something they show?


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## Petloversdigest (Dec 10, 2010)

I can't see how a small porion of normal food will make any difference to Lion, in the grand scheme of things...The antibiotics are a different matter though, as the concentration can drop below what is needed to kill the bugs if the full dose isn't given at the time required. Good luck finding a food treat that makes this possible - that is always the easiest solution but Lion may have other ideaas on the subject.....


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## voxie (Jan 16, 2011)

jomary-austin said:


> You will know when the time comes. If he has lots more bad days than good days then you need to think about it seriously as it is not only miserable for your cat but also really painful for you to witness your cat in decline. But while he's eating and enjoying contact with you he's fine, cat's don't think like us, there are know what ifs and if onlys, they live for the moment and accept things. Apparently CRF feels like a big hangover so isn't actually painful but not pleasant either.
> 
> If you are having doubts about euthanasia now then it clearly isn't the right decision. You will definitely know when it is the right time to let him go and it isn't now.
> 
> Wishing you all the best.


Thanks jomary-austin, as well as everyone else for their heartfelt comments xx

With what you said about CRF feeling like a big hangover, Lion does seem like that today. It's really difficult... Sometimes I feel like I'm losing hope when I see him like that. He is enjoying our company and purrs as normal once he's on our laps though. When he's left alone however, he does have that slight hungover look on him.

I'm going to get the rest of his antibiotic and appetite pill down him now and hope this improves his mood for tomorrow. :thumbsup:


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## Cazzer (Feb 1, 2010)

Glad he's home and a bit better. Get a tube of primula prawn flavoured cheese spread and mush up about a cm with the tablet. I've had to medicate 2 very difficult NFC this week and this has made it very easy. They lick it off my fingers! At worst you can easily smear it into his mouth.


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## Ianthi (Oct 21, 2008)

voxie said:


> Hi there Ianthi,
> 
> I did ask, and the vet's reaction was sort of like,he didn't believe there was a chance it could be kidney stones. He also mentioned the bills would be high. Money really isn't an issue to me with this. If his condition doesn't improve by the next appointment (next Wed/Thurs), I may have to ask again.
> 
> Is there anyone out there who has had a cat with kidney stones? Kidney stones I imagine can be quite painful for cats - Is this something they show?


Hi Voxie!

I'm glad to hear the fluids succeeded in bringing the urea levels down to within normal levels. Creatinine is more of a marker for the condition and should be around 170 mark to be within normal levels and if it's now at 400 it's likely he'll need additional fluids to being it down further. I would discuss giving Sub-Q fluids at home. Some vets though not all permit this.

Kidney stones/infections are very often the cause when the cat presents with very high numbers ( Acute Renal Failure ) as in Lion's case and it's perfectly possible the fluids have managed to flush out one already. If this is the case they are usually lodged in one of the ureters. Did Lion have one kidney larger than the other? They're more common that vets think I'm afraid-on Tanya's site there have been a few cats that have had them.

As the others have said it's extremely important he has those meds and continues to eat. I wouldn't worry at all about the small amount of 'normal' food being dangerous-it's best though if he stays on renal food ( low phosphorous ) though. Have you tried putting the meds in small portions of cheese/ham/chicken? You can divide the antirobe ( know it tastes foul! ) into two portions. At least that way you're not putting him off his food because it's laced with a substance he clearly smells and is able to taste!! And the last thing you want is an inappetent CRF cat! I found those treat sticks in Tesco ( cat food section ) were very good for hiding meds in them! You can cut off as much as you require and cats in my experience do like them.

I would strongly recommend you join Tanya's CRF site where lots of experienced people are dealing with cats like Lion on a daily basis-it's a fantastic source of advice and support and people there currently have cats who've recovered from initially very high numbers even higher than Lions!

Here's the link to the site-it will give you lots of information and help in specific sitions.

Tanya's Comprehensive Guide to Feline Chronic Renal Failure

and there's a link for the joining the group on the site

I hope Lion continues to improve and keep us updated!


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## bellathemog (Sep 30, 2010)

Great to see the old boy home and better.

Next time if your worried about the normal food as the vet for a Binder paste which you mix into the food, this breaks down normal none kidney friendly foods. I use this with bell I mix it up in the wet food and she laps it up.

Ref the tablets ........... try them in as many "strong" tasting foods you can, so he doesn't smell/taste the tablet.

I use - ham, cheese and at the moment cornbeef not alot!! just enough to cover the tablet.

I've learnt with bella that if you pop the tablet in the food, lay it on the kitchen floor she will snif it and then i'll start the classic rubbing her side/back and this works, for some reason eating ham filled tablets in her bowl she wont do.


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## voxie (Jan 16, 2011)

Hi there everyone 

Lion is sooo much better today!

Despite all the capsules wasted yesterday, today I managed to get him to eat a capsule first time! By tucking it into his favourite pork recipe (adobo). I simply got one of the fork prongs, made a hole, and squeezed the pork inbetween.

I have many peoples' advice here to thank for this  I don't know why the vet recommended emptying the capsule contents into the food instead (perhaps because of Lion's sore gums, maybe) - cat's have far too great a sense of smell.

I would highly recommend getting your cat to eat a whole capsule within his favourite food rather than mixing in the powder.

Lion's antibiotics have kicked in, and he is eating and drinking lots - he's currently in the garden, checking up on his territory like a normal everyday cat. I'm so happy 

*Lion's state today:* A bit sloshy in the morning and early afternoon. But once antibiotics kicked in, amazing compared to yesterday - Alert, coherent and territorial.


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## Petloversdigest (Dec 10, 2010)

Great stuff - glad all is well :thumbup:


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## Ianthi (Oct 21, 2008)

Really good news Voxie! 

Glad you've found the best way to pill him! I always find it better as well to give the pills before meals ( ie when hungry ) and follow it up later with food!

Antirobe may taste foul but it's very good for mouth problems!


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## Kiwi (Nov 18, 2010)

So pleased you succeeded with the pill and he is feeling a bit perkier x


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## mrswoodwoose (Jan 23, 2011)

Hello I am wondering how Lion is doing? x


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## voxie (Jan 16, 2011)

Hey everyone - many thanks for all your nice comments and advice ^^ between yourselves, my vet and my friends & family, you've been all the "therapy" I've needed... 

Lion went for a check-up at the vet today, having been at home since last Friday. And the results are good! Lion is much better compared to before he arrived at the vet 2 weeks a go! He's eating more and toileting normally. and he's gained weight! However, yesterday and the afternoon before, Lion had vomited. The vet didn't say anything about that though... His sore gums and teeth have also calmed down. I suppose it's the Antirobe to thank for that, as Ianthi mentioned above!

All in all, it was good Lion was eating and digesting somewhat normally. He also seemed livelier, fighting off two vets when attempting to take his blood for testing!

The vet also gave Lion some fluids while he was there, and gave me more Antirobe to replace those I had wasted over the weekend!

The vet will give me a call tomorrow and let me know what his blood test results will say... Fingers crossed they are lower. As I said to John (the vet), I'm really not sure if Lion's condition is coming or going, and it's heartbreaking.

Will post results here when I know! x

*Lion's state today:* Lively, almost normal. Even asked to go out in the garden this evening!


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## Kiwi (Nov 18, 2010)

Aaaw Voxie  fingers and paws crossed here for the results xx Glad to see lion is still putting the vampire vets in their place tho!


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## voxie (Jan 16, 2011)

Ianthi said:


> Kidney stones/infections are very often the cause when the cat presents with very high numbers ( Acute Renal Failure ) as in Lion's case and it's perfectly possible the fluids have managed to flush out one already. If this is the case they are usually lodged in one of the ureters. Did Lion have one kidney larger than the other? They're more common that vets think I'm afraid-on Tanya's site there have been a few cats that have had them.


Hey Ianthi 

I'm going to mention kidney stones again tomorrow, if the kidney levels are better - Because perhaps that's what it was. If the kidney levels are worse, I will ask about giving fluids at home, if Lion's condition worsens. The vet is only 15 mins away though, so if it's cheaper to bring him every few days, I may do that instead.

All depends on tomorrow... :001_unsure: Will certainly post the verdict xx


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## voxie (Jan 16, 2011)

colette85 said:


> I agree completely! Ruling out the very obvious cases where it's the only course of action some vets initial response is to PTS without instigating any treatment at all! How will you know if you don't try? In the UK this is particularly true where CRF is concerned even in cases where diagnosis is made in the early stages!! I know in some instances the welfare of the animal is at the forefront of their thinking and they wish to prevent any further suffering, but I also believe in quite a number of cases it's a reflection of the competence level of a lot of vets regarding this condition in particular, hence this gloomy dismissive approach!
> 
> Frankly, I've lost count of the number of people who's original vet wanted to PTS who upon consulting elsewhere, the pets went on to live for many happy years! Vets are not infallible and it's always worth getting a second opinion!
> 
> In Voxie's case I'm particularly concerned the vet hasn't ruled out infection as a cause especially since the initial renal numbers were soo high-it should have been the first response to at least rule it out IMO!


Hey colette85 

I totally agree, PTS seems to me like a too easy answer doesn't it? That's why you can't always trust doctors, whether it's for human or animal. Thank God we have the internet, where like-minded people can meet on forums like this one, and offer support and advice a lot closer to home - nothing any hospital could really offer. :thumbsup: Of course, I'm not saying doctors are always wrong. I'm just saying that their suggestion or recommendation doesn't always have to be the be all and end all..!

And the vet didn't rule out infection, just kidney stones (he said it's very rare for cats), he does indeed believe he is a CRF cat. Sorry if I've confused you or if I have been confused! hehe ^^


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## Ianthi (Oct 21, 2008)

voxie said:


> Hey everyone - many thanks for all your nice comments and advice ^^ between yourselves, my vet and my friends & family, you've been all the "therapy" I've needed...
> 
> Lion went for a check-up at the vet today, having been at home since last Friday. And the results are good! Lion is much better compared to before he arrived at the vet 2 weeks a go! He's eating more and toileting normally. and he's gained weight! However, yesterday and the afternoon before, Lion had vomited. The vet didn't say anything about that though... His sore gums and teeth have also calmed down. I suppose it's the Antirobe to thank for that, as Ianthi mentioned above!
> 
> ...


Hi Voxie,

This sounds promising indeed-the fact he's eating well and has put on weight are both good signs. Hopefully the bloodwork will also have come down but it's always a case of treating the cat and not the numbers so if otherwise don't be disheartened by this! The best marker is how the cat is behaving! If the vomiting becomes persistent the vet can prescribe something for this but I wouldn't worry too much about two occasions.

I wonder why I haven't mentioned this before but there could also be a connection between his gum problems and the kidney problems. I'm only surmising here, there's a cause effect relationship between the two . The fact he's managed fairly well without fluids though leads me to believe it's most likely a stone (that was flushed out) or infection related. Usually with standard CRF regular fluids are required to maintain levels after an initial stint to bring them down, that is! By the way if infection is the cause Lion would need to be an antibiotics for at least 4-6 weeks to clear it completely, so bear this in mind!

It would probably be cheaper ( and easier on Lion! ) to administer fluids (if deemed necessary ) at home though you'd probably have to be shown how it's done!

Looking forward to hearing blood results tomorrow!


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## bellathemog (Sep 30, 2010)

So happy to see another cat fighting hard to get better, he is like my bella a true fighting tabby moggie machine.


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## voxie (Jan 16, 2011)

Hey all,

Yesterday, the blood test results weren't good - Lion's creatinine levels (which prior to seeing the vet were in their 600s, then brought down to the 400s when staying over with them for 4 nights) had now risen to their 800s!!

The vet apologised and said that despite Lion looking better today, he can see this going sideways.

This is initially upsetting, as perhaps it's not a flushed kidney stone at all. I had mentioned getting Lion a scan, but the vet said, with these blood test results, it's likely not a stone and the costs wouldn't be worth it. Lion's kidneys are also a normal size, with no kidney bigger than the other.

I feel partly upset, but then I look at Lion walking and jumping around the house, with the newly restored glow in his eyes, I can't really believe the vet's words.

Lion has another check-up next week. I also questioned if I could give him fluids at home, and the vet was surprisingly enthusiastic about it - he will give me a tutorial next week! He recommends it being done at least 3 times a week.

I am to treat Lion as normal with Antirobe everyday. He can also start eating normal food, with this special powder mixed in called Ipakitine (as Lion has been getting bored with his Hills food!).

So, bad news in the numbers, but still very much good news with Lion's condition. I don't know what to believe, or how to really feel. I'm just enjoying spending time with Lion when I can... But with deep hidden feeling that this can be taken away from us at any given time. I won't cry about it though, not while Lion is as happy as he is at the moment. How could I? 

*Lion's state today:* Pretty much normal on the outside, despite the numbers on the inside.


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## voxie (Jan 16, 2011)

Ianthi said:


> Hi Voxie,
> I wonder why I haven't mentioned this before but there could also be a connection between his gum problems and the kidney problems. I'm only surmising here, there's a cause effect relationship between the two .
> 
> It would probably be cheaper ( and easier on Lion! ) to administer fluids (if deemed necessary ) at home though you'd probably have to be shown how it's done!


Hi Ianthi! 

Well, the vet mentioned it may have been a problem underlying before the kidney disease kicked in. Which then flared up when the kidney disease did. He hasn't really mentioned anything else, so I'm unsure if there is a connection. His mouth has gone down now, and is nowhere near as sore as before!

And yes, the vet said I could start giving Lion fluids a home from next week, so I'm happy about that. 

Thank you again for your experience & advice! xx


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## Petloversdigest (Dec 10, 2010)

voxie said:


> Hey all,
> 
> Yesterday, the blood test results weren't good - Lion's creatinine levels (which prior to seeing the vet were in their 600s, then brought down to the 400s when staying over with them for 4 nights) had now risen to their 800s!!
> 
> *Lion's state today:* Pretty much normal on the outside, despite the numbers on the inside.


Sorry to hear about the test results - how right you are to judge how Lion is, and not the pieces of paper........:thumbup:


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## Ianthi (Oct 21, 2008)

voxie said:


> Hey all,
> 
> Yesterday, the blood test results weren't good - Lion's creatinine levels (which prior to seeing the vet were in their 600s, then brought down to the 400s when staying over with them for 4 nights) had now risen to their 800s!!
> 
> .


Hi Voxie,

Sorry to hear about the rise in numbers but considering Lion's condition otherwise ( which is a way more important indicator ) I wouldn't become too despondent at all! The good news is that with the fluids ( really glad to hear the vet agreed! ) these numbers can come down. The Ipaktine, which is a phosphorous binder in the food should also help. I'd imagine with a creatinine of 800 his phosphorous was also high and considering this can accelerate the CRF it's extremely important to keep it low. The other thing to keep an eye on is blood pressure-it's likely his ( with CRF ) is high and the vet can prescribe something for this-so do have it checked on your next visit! Potassium levels can also be a bit low although it doesn't sound at this stage that Lion's are but ask the vet just in case! Anaemia is another thing to watch out for but again very treatable like a lot of the other related symptoms. Sorry don't mean to overwhelm you with all this-only showing you that treating these can impact on lowering numbers and the wellbeing of the cat!

The kidneys in a CRF cat are usually smaller and shrunken unlike their non-CRF counterparts.

Also for ongoing support from now on, expecially with the fluids I strongly recommend you join the Yahoo group. For one thing you'll discover that lots of people on the forum have had cats with similar numbers to Lions which they have successfully managed to lower and stabilise for years afterwards-this should encourage you! They are also brilliant at giving advice and support!

Good luck with your first tutorial and let us know how it goes!


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## Kiwi (Nov 18, 2010)

Ianthi said:


> Good luck with your first tutorial and let us know how it goes!


Ditto. Delighted to hear that he's doing well and holding his own!


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## voxie (Jan 16, 2011)

Ianthi said:


> Hi Voxie,
> 
> Sorry to hear about the rise in numbers but considering Lion's condition otherwise ( which is a way more important indicator ) I wouldn't become too despondent at all! The good news is that with the fluids ( really glad to hear the vet agreed! ) these numbers can come down. The Ipaktine, which is a phosphorous binder in the food should also help. I'd imagine with a creatinine of 800 his phosphorous was also high and considering this can accelerate the CRF it's extremely important to keep it low. The other thing to keep an eye on is blood pressure-it's likely his ( with CRF ) is high and the vet can prescribe something for this-so do have it checked on your next visit! Potassium levels can also be a bit low although it doesn't sound at this stage that Lion's are but ask the vet just in case! Anaemia is another thing to watch out for but again very treatable like a lot of the other related symptoms. Sorry don't mean to overwhelm you with all this-only showing you that treating these can impact on lowering numbers and the wellbeing of the cat!


Thanks Ianthi - I will indeed ask the vet about his blood pressure. Saying that, they hadn't given me any pressure results before, I am wondering if they had ever checked it! I'm guessing they must have if they've taken blood samples as well.

Regarding his high phosphate levels, I'm wondering if part of the reason might be some of snacks we feed him at the table (which weren't powdered with Ipaktine). I am going to have this restricted from now on.

Lion hasn't been taking his Antirobe properly for the passed three days - eating only half and leaving the rest, or spitting it out altogether! His condition seems okay though... I hope this does't affect him overall. Will cook his special recipe pork tonight just to makesure he devours an entire capsule.

And I will certainly join the Yahoo group, thank you for reminding me! 

*Lion's state today:* Lazy, but playful. Less of an appetite - fussier with food.


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## Ianthi (Oct 21, 2008)

Hi Voxie,

Vets have to use specialised equipment to take blood pressure ( similar to humans ) and it's entirely separate to having blood taken. I hope your vet has the equipment-not all do unfortunately!

If Lion was on a renal food prior to this then this should control phosphorous levels and the odd small snack shouldn't matter too much. Do get a copy of his bloodwork results though before you join the Yahoo group-you need them in order to target the treatments more specifically and to monitor progress at a later stage.

Do persevere with the Antirobe though-otherwise the infection will return!

Good luck with it all!


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## voxie (Jan 16, 2011)

Hi there all, 

Just thought I've give a quick update on things. Including smaller things. Sorry in advance if I ramble a bit!

*Last Saturday 5th February*
Lion went to the vet's last Saturday, and they gave him fluids and topped up his does of Antirobe and Mirtazipine. (This man was a different vet, the usual one (John) was away getting his wisdom pulled out.) Anyway, I mentioned having fluids given at home and he said it can be done etc. Great, so I was expecting to be tutored on this today! I also asked him on how long he think Lion has left, he said these guys can crash within a matter of days to a few weeks... He then asked me to leave the room as he gives Lion. So I waited at reception. Then 10 minutes later Lion was returned to me by another girl. The other vet had then called in another customer! :confused1:

It was so fast, I even forgot about getting a copy of his bloodwork results!

I asked reception about being taught on giving fluids at home, she said it's best left next week.

Really felt like I was being ushered away, like they had given up on Lion as he hadn't a chance... But I let it go, as this isn't the vet I usually see.

Upon bringing Lion home, he seemed a bit anti-social, hiding on our high kitchen cupboard - he rarely goes there. He really, really hates the vet's, mostly their needles!

Last week I had gotten really distressed, with Lion not taking his antirobe properly and seemingly slipping back into his dozed look again... Even I've been losing hope. I partially suspect it's because he hadn't taken his mid-week Mirtazipine tablet properly though, as he seemed to be losing his appetite in general. He was given another dose by the vet today, and he seems to be back to eating lots again! 

*Sunday 6th February*
Finally, I found a guaranteed way of getting Lion's antirobe swallowed - sneaking them into cat treat sticks (as Ianthi had mentioned previously - thank you!)! Highly recommend this to anyone having trouble giving capsules to their cat.

Last week, he even refused eating his inside his favourite pork recipe. I had been trying to give him manually but opening his jaw, but this felt like it was too chancey, and it was very distressing, for both of us. I wish I got the treat sticks sooner! (Though again, he might have been refusing it due to lack of appetite, and not digesting his Mirtazipine properly - I suspect this might have been lost in vomit). Speaking of vomit...

*Monday 7th February*
For the past few days, for dinner I've been giving Lion some normal food mixed with Ipakitine Powder, as he is very bored with his renal diet food now. For breakfast and lunch, he has renal diet food. For dinner he has normal food mixed with Ipakitine. Later this evening, around 2-3 hours later, he vomited (the normal food I presume)... He did this the night before too. I don't see this as a great sign at all. I'm guessing this is due his high creatinine levels, and his normal food given is still too high in phosphate to properly digest. Perhaps I'm not mixing in enough Ipakitine?

Most of last week he had been toileting normally though, so the food seems to have been going through. Lion's physical condition also seems okay most of the time. He does seem a little dozy and unwell at times. But he is definitely more interactive than he was four weeks a go!

I feel like my cat is a live experiment right now, and I'm having to be the vet for him! God Bless the Internet! I don't think Lion would be alive right now if it wasn't for this forum...

Lion's next appointment is this Saturday, where I will drill the home fluids treatment into them. I don't think it's fair on Lion otherwise!

*Lion's state today: *Sociable, affectionate. When left alone, sits upright alot (like in the attached picture), with a sleepy look in his eyes (I don't think he's feeling very well at the moment).


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## Ianthi (Oct 21, 2008)

Hi Voxie,

Sorry to hear of your experience with this other vet. It's such a pity he didn't use the visit to show you then and there how to give the fluids at home instead of ushering you outside! From now on just avoid him in future and just see the other more pro-active one next time.

Ideally Lion should be receiving fluids (less stressful if given at home ) more frequently than once weekly with creatinine levels this high in order to lower and stabilise them. Of course he might be drinking enough to keep himself hydrated but even so it isn't enough to effect a decrease in levels which is what you want. Remember last time his levels increased again on cessation of fluids.He'll also feel a lot better. I would certainly ask ( the former! ) vet about this as soon as possible. Don't forget about the blood pressure check either.

Ipaktine-amount is based on weight of cat. The vomiting could be due to a number of thinks-the antibiotics for one thing or stomach acid (a sure sign is if he vomits 'white foam' - easily treated with slippery elm bark-capsules from Holland and Barret ) which CRF cats suffer from. In fact, I'd buy some soon and since you're bound the need them at some point and especially if the vomiting perists! Dehydration is another cause. Don't worry too much about isolated episodes, but if it persists mention it to the vet though especially if it's accompanied by lack of appetite.

It's good to hear he's eating though I'm sure the Mirtazipine is helping a lot here!


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## Paddypaws (May 4, 2010)

So glad to see that your cat is doing better, lots of praise to you for being willing to go the extra mile!
I see Ianthi mentions slippery elm capsules above to help sooth his stomach....I use this quite a lot ( I buy the powder loose )
Baldwins Slippery Elm Bark Powder (ulmus Rubra) | Herbs S | Herbs, Roots, Barks, Powders & Dried Flowers | G. Baldwin and Co. | Herbalist UK
and would suggest that maybe you open the capsule and mix it up with a small knob of butter, or that Primula cheese. My cats will normally lick this mix off a spoon....but if they are reluctant I smear it down the front leg and they lick it off to clean themelves, still easier than feeding yet another pill.
You can also ask your vet about an Antacid ( I use Famotidine, but I believe Ranitidine/zantac is also recommended on Tamya's CRF site ) These are both human meds, but can really sooth a 'sore tummy' and encourage the cat to eat.


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## voxie (Jan 16, 2011)

Hello Ianthi and Paddypaws,

Thank you for your recommendations on Slippery Elm Bark, I did see this on Tanya's site and had been thinking about it. There is a Holland & Barratt near where I am, so I'll pop in and ask for these capsules - hopefully they're not too big to fit into a treat! Otherwise, I'll go for the powdered version.

Would anyone know if Slippery Elm Bark is okay to take alongside the Antirobe? I should probably ask the vet on Saturday, but if anyone knows, it'd be good to hear!

Thank you again for everyone's advice!


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## BSH (Jul 28, 2010)

Ianthi said:


> I'm sure the *Mirtazipine* is helping a lot here!


Are they using Mirtazapine as an appetite stimulant? We use it as an anti-depressant in humans.


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## Ianthi (Oct 21, 2008)

voxie said:


> Hello Ianthi and Paddypaws,
> 
> Thank you for your recommendations on Slippery Elm Bark, I did see this on Tanya's site and had been thinking about it. There is a Holland & Barratt near where I am, so I'll pop in and ask for these capsules - hopefully they're not too big to fit into a treat! Otherwise, I'll go for the powdered version.
> 
> ...


Voxie - here is more information of Slippery Elm Bark and the cautions where other medications are concerned.

Tanya's UK Feline Chronic Renal Failure/holistic methods

It comes in standard capsule size, a bit big for inside a treat, I'm afraid! I usually open it and mix in with food. My cat doesn't have a problem with appetite though and never notices! Best iin Lion's case to perhaps just open and put a little in a few treats-last thing at night is a good time because the effects of stomach acid are worse when the stomach is empty! Also please note it contains *calcium* and if Lion's has already high levels ( blood test results ) it best not to use too much because it can drive levels up further. Ask vet just in case!

Is he still vomiting? If not you could hold off giving it for a while if it means you have problems with giving additional meds!

How is he today generally?


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## Ianthi (Oct 21, 2008)

BSH said:


> Are they using Mirtazapine as an appetite stimulant? We use it as an anti-depressant in humans.


Yes, it's the same one! Apparently quite a few cats have experienced problems ( restlessness, hyperactivity! ) with it -though not in Lion's case!


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## voxie (Jan 16, 2011)

Thanks all for your advice!  - The Holland & Barratt only had the slippery elm bark tablets in stock, and they were huge! Luckily they're a bit chalky and easy to cut.

*Tuesday 8th February*
Lion was begging for food when I came in from work, with his big cute eyes. I gave him quite a few bits of the treat sticks, as the antirobe capsule I squeezed into each kept falling out. He ate it eventually! I then gave him some normal cat food (seems to love Whiskas' Oh so Fishy! atm) mixed with 2 scoops Ipaktine, as Lion has lost weight and is very light right now.

I also bought the slippery elm bark tablets today. I wasn't sure how much to give him, but Paddypaws here had mentioned capsules - which, on looking them up, measure at 370mg. The tablets are 400mg, so I estimated just over 2 thirds of it would be enough for Lion - also his kidneys probably shouldn't get much, especially because of the calcium ingredient... Thanks to Ianthi for making this clear - I wouldn't recommend doing this without checking with your vet first. I just chanced upon this, as his vomiting seemed to be getting severe.

*Wednesday 9th February*
And huzzah, Lion hasn't vomited at all since taking the slippery elm, so I'm thinking it's working! Gave Lion his antirobe within a treat stick as normal. He isn't eating as much food as yesterday though. Tried giving him a small piece of slippery elm in a treat after his meal. He wasn't interested! His last bit of Mirtazapine was only yesterday, though it was one of the smaller quarters (it's a pill usually cut by hand into 4 quarters - vet didn't do it for me this time, so I had an awkward hand at it!).

Lion's been noticeably losing a lot of weight since earlier last week. I can feel his ribs more. I also think he's dehydrated.

*Thursday 10th February*
I come home from work at 8pm, and Lion's not eaten his food left for him this morning... I replaced with normal Ipaktine-mixed food, and he didn't even look at it. I've even tried wiping a bit of the jelly on his nose, so he can lick it off and maybe whet his appetite - no luck.

He's sleeping a lot, and is obviously dehydrated. I am wondering if he's crashing. But when he interacts with me, he's jumping up and down tables and being affectionate, coming over and snoozing on my lap. It's difficult to tell... I've so perplexed, I even wondered if this is his way of telling me to let him go?

I keep putting him by his food to help him eat. In case it's because he feels uncomfortable, I've raised his food bowls above stomach level (as recommended on Tanya's site to ease acid reflux) - I've been doing this the passed couple days, and it doesn't seem to be making a difference, though I haven't had time to observe much eating really.

I've made another small quarter of his Mirtazapine into a paste and wiped it on his paws (thank you Paddypaws for this tip!). I think he has licked some of it off, but we'll see if it'll make a difference.

I'm worried about him, can't wait to bring him into the vet's on Saturday...

*Lion's state today: *Dehydrated. Hardly eating and drinking, losing a lot of weight since early last week.


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## voxie (Jan 16, 2011)

Ianthi said:


> Yes, it's the same one! Apparently quite a few cats have experienced problems ( restlessness, hyperactivity! ) with it -though not in Lion's case!


Actually, there was a weird moment last week when he ran around and jumped on top of the living room stereo at a hastier-than-usual pace! It was so out of the blue, I was wondering if his kidney's were affecting his mind! Now I know what it was!


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## voxie (Jan 16, 2011)

Ianthi said:


> Is he still vomiting? If not you could hold off giving it for a while if it means you have problems with giving additional meds!


He hasn't vomited at all since Monday! So I think it's working. I won't be giving him anymore though. I'll wait until Saturday to ask the vet. Thank you for the warning. Better to be safe than sorry.


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## voxie (Jan 16, 2011)

Paddypaws said:


> So glad to see that your cat is doing better, lots of praise to you for being willing to go the extra mile!
> I see Ianthi mentions slippery elm capsules above to help sooth his stomach....I use this quite a lot ( I buy the powder loose )
> Baldwins Slippery Elm Bark Powder (ulmus Rubra) | Herbs S | Herbs, Roots, Barks, Powders & Dried Flowers | G. Baldwin and Co. | Herbalist UK
> and would suggest that maybe you open the capsule and mix it up with a small knob of butter, or that Primula cheese. My cats will normally lick this mix off a spoon....but if they are reluctant I smear it down the front leg and they lick it off to clean themelves, still easier than feeding yet another pill.
> You can also ask your vet about an Antacid ( I use Famotidine, but I believe Ranitidine/zantac is also recommended on Tamya's CRF site ) These are both human meds, but can really sooth a 'sore tummy' and encourage the cat to eat.


Hi, Paddypaws! Have your cats been suffering from CRF too? For how long?

And I should really try that Primula cheese. However, I remember reading somewhere that CRF kidneys should avoid milk. As cheese has milk, is it safe...? Or will a little bit do no harm?


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## voxie (Jan 16, 2011)

Ianthi said:


> My cat doesn't have a problem with appetite though and never notices!


Hey Ianthi! So if your cat suffering CRF also??


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## Ianthi (Oct 21, 2008)

No, IBD and more recently pancreatitis. Slippery elm is also good for coating the digestive tract and calming down the inflammation.

How's Lion?


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## voxie (Jan 16, 2011)

I see - I hope your cats are doing well and being strong 

Lion has been in the same state the passed 2-3 days - not eating, but drinking, being dozy... Very worried. Going to the vet soon. x


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## voxie (Jan 16, 2011)

Hi again,

I've just come back from the vet, and as I suspected, Lion is very, very dehydrated. Possibly the most dehydrated they've ever seen. I told John (the usual vet!) it's possible that he failed to digest his Mirtazapine on Tuesday, maybe regurgitated in the garden where I didn't see? The vet said that it could just be the toxins in his kidneys... Is he suggesting that perhaps his toxins are now so high, the Mirtazapine is no longer having an effect?

I told John that for the passed 2-3 days he has had no appetite at all, and I haven't given him his antirobe for 2 days because of this - Lion finds manually opening his jaw just too distressing, so I avoid that now.

I asked about Lion's blood pressure - The vet said he could tell just by looking at him that his blood pressure is pretty low. High blood pressured cats usually swell up. As Lion's very dehydrated, his blood pressure will be very low.

The vet said, at this point I have to options:

To put him down.
To put him back on the drip.
I looked deep in Lion's tired eyes.... Of course, I know the situation is terminal and it can't cured. But until Lion gives up, I won't give up. The vet understood it's very hard, and that I adore him and it's very emotional for me.

I asked him if he thinks it's best to put him down. John suggested taking Lion in for a few days and flushing him out again, returning him home possibly Tuesday. But, he can see in a month's time, being in the same situation as today again.

After some discussion, it was agreed that after returning home, Lion would be dropped in 2-3 times a week for fluids. The vet suggested this, as even though giving fluids at home is a possibility, it can prove very distressing. As the vet is doing it atm, "Lion hates us already", he said, "but if you do it at home as well, it'll be even more stressful. You don't want him hiding behind the couch and things like that". As Lion _hates _needles, I agreed this would be best... I would want him to feel comfortable and at peace at home, not stressed out and scared of us.

And to be honest, with popping a pill in Lion's throat being distressing enough, I don't know how I'll handle giving him fluids at home! So I think it's best. 

Thank you again for everyone's support and kind words on this forum! You've been quite literally, a lifesaver! 

Edit: You know, I totally forgot to bring the slippery elm bark tablets with me and mention I gave him a dose on Tuesday! I will have to tell the vet when he gives me a call tomorrow.

*Lion's state today: *Very dehydrated. Very dozy. Glad that he will be back with the vet a little while...


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## BSH (Jul 28, 2010)

Hello Voxie,

So sorry to hear Lion is not doing so well again  It is an awful predicament to be in, and I speak from personal experience as my cat Bracken was in exactly the same situation as Lion is now.

You need to do what you think is right for Lion, guided by your vet, who sounds like a sensible chap.

Sadly we decided to let Bracken go to sleep. We didn't feel that a few distressing days at the vets (she hated the vets, bless her) for the sake of a few days back at home, and then returning to the same situation again the next week was fair on her. This is not to criticise your decision, we all have different viewpoints on what is the best way forward in such difficult situations, and I respect yours.

Thinking of you at this difficult time for you.


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## Ianthi (Oct 21, 2008)

Hi Voxie,

Sorry, I missed your last update this week - thought it was the former one so just skipped it unfortunately!

Sorry to hear latest news! A few things strike me though! Bearing in mind that Lion was coping extremely well before with very high creatinine numbers-eating well etc I wonder if at this stage he is *anaemic* also? I would certainly ask the vet to check for this as it could also explain why he's become weaker and less inclined to eat in the last week! Since it's a _very _common consequence of CRF-especially later stage-I think your vet needs to test for it ( only requires a small sample of blood if necessary ) because it can and needs to be treated! I don't remember you mentioning it before but it is a very strong possibility!

I've no doubt Lion will be improve at the vets! Of course as I mentioned in an earlier post he will need regular fluids to remain stable what is remarkable about him is the way he appears to be coping very well despite the high renal values! So bear this in mind!


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## voxie (Jan 16, 2011)

Hi all 

The vet called me twice yesterday with updates:

First call he said he had taken a blood test, and despite Lion's Urea levels being off the scale (which had been brought down before), his creatinine levels, which were in their 800s two weeks a go, had come down to the 600s. We both found this strange, but of course, good news. (The vet was expecting to see the creatinine in their 1000s.)

The second call was to let me know that Lion had start eating, which I was happy to hear (since he had had no appetite for the passed few days)! I had guessed that this was due to Lion was digesting his Mirtazapine properly. But, the vet told me he had not given Lion any Mirtazapine - only fluids via drip! :scared: This is again, surprising but good news!

The vet will give me a call later today to see how he's getting on... Will keep it posted here.


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## voxie (Jan 16, 2011)

BSH said:


> Hello Voxie,
> 
> So sorry to hear Lion is not doing so well again  It is an awful predicament to be in, and I speak from personal experience as my cat Bracken was in exactly the same situation as Lion is now.
> 
> ...


Hey BSH,

I'm sorry to hear you had to go through a similar situation with Bracken - may she rest in peace. As you say, it's not an easy situation to be in at all, and my respect to you for sharing your experience. And of course, no criticism taken!  Every cat is different according to each situation.


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## Ianthi (Oct 21, 2008)

Was this blood test before the fluids Voxie? If this is the case that's exactly what I meant in my last post that something else is at root this recent decline! Do ask about the anaemia though if only to see if vet has checked it - it's really important to address it if it's a problem!

Also as far as I remember infection in Lion's case has never been ruled out and you might like to remind the vet about this as well! For a cat who's had _very_ little fluids relative to those high numbers and for them to stabilise not to mention decline, strongly suggests to me there's something else going on here and infection could well be one of them!

The fact he's eating without an appetite stimulant is a very good sign indeed!


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## voxie (Jan 16, 2011)

Hi Ianthi! 

I will certainly ask about anaemia and the possibility of kidney infection - thanks for bringing this up to me! There are some strange turns here, so it's probably best to have everything checked.

Also, for the passed 2 weeks he's been at home, I have been mixing Ipakitine in Lion's normal food, as well as giving some renal diet food. I was wondering if this was helping his creatinine levels lower... I'll be asking this as well.

Will keep you updated!


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## Ianthi (Oct 21, 2008)

Yes, the Ipaktine would assist with keeping levels down ( limiting phosphorous ) but not to that extent! Usually cats with those levels would need _daily_ fluids to effect a decrease so frankly it's remarkable that virtually in their absence the levels decreased on their own! I'm still thinking about the infection in his mouth - could well have impacted on kidneys!

Your vet sounds nice but think he needs a nudge or two in the right direction!


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## voxie (Jan 16, 2011)

The vet just called - Lion is still doing well, eating and drinking, without aid of an appetite pill!  He said he will try giving him some Mirtazapine later on today, just to see what he does.

I asked about anaemia, as this may have been what's affecting Lion's behaviour the passed few days. The vet said most renal patients _would _be anaemic, yes. He mentioned that treatment would be expensive (£400 p/week), and would mean giving him a hormone injection to increase red blood cell productivity. However, the results are only temporary, and the costs are extremely high.

Also, due to the strange turns in his response and kidney levels, I asked about the possibility of kidney infection, rather than kidney disease. The vet said that they know these patterns very well and he's most likely CRF cat... But tomorrow, once the fluids and food have run more of a course through Lion's body, they will be giving him another full blood test, including haemoglobin readings for anaemia.

Will post the results once I know. Fingers and paws crossed... xxxx


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## BSH (Jul 28, 2010)

The vet is right, patients I treat with CRF are almost always anaemic (known as anaemia of chronic disease). This is treated with erythropoietin, but it is extremely expensive and requires regular administration for life.

Glad to hear he has picked up a bit.


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## Ianthi (Oct 21, 2008)

voxie said:


> The vet just called - Lion is still doing well, eating and drinking, without aid of an appetite pill!  He said he will try giving him some Mirtazapine later on today, just to see what he does.
> 
> I asked about anaemia, as this may have been what's affecting Lion's behaviour the passed few days. The vet said most renal patients _would _be anaemic, yes. He mentioned that treatment would be expensive (£400 p/week), and would mean giving him a hormone injection to increase red blood cell productivity. However, the results are only temporary, and the costs are extremely high.


The hormone injection would only apply to more severe cases and it doesn't sound as if Lion falls into this category! However it's extremely important to treat it as if left untreated it can kill!

In the meantime ( depending on the PVC result ) vitamin B or iron injections can help to keep it at bay. I assume he's still on Antirobe?

Hope the results are good!


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## voxie (Jan 16, 2011)

Hi all,

Just to update...

*Monday 14th February*
The vet called disappointingly with news that Lion's kidney figures haven't budged, despite fluids being given constantly since Saturday... He does have signs of anaemia, but it wasn't a major issue. He told me, in a way to prepare me, that this doesn't look good.

He said he will give fluids until Wednesday to see how he does...

*Tuesday 15th February*
The vet called with news that Lion's creatinine levels have been brought down to the 600s, but the urea is still off the scale. The vet also noticed one of Lion's kidneys were a little bigger, and went ahead and did an ultrasound scan (which annoys me a bit, as I had already suggested this 2 weeks a go). He found signs of what looks like Lymphoma.  He suggested giving him an injection (of what I heard on the phone to be pronounced HydroQuarterZone) to boost his immune system.

He said he'll give me a call this afternoon to let me know how he's getting on, but so far, it doesn't look good...

Hoping to go see him after work today. Will keep things updated!


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## BSH (Jul 28, 2010)

voxie said:


> He suggested giving him an injection (of what I heard on the phone to be pronounced HydroQuarterZone) to boost his immune system.


Sorry to hear Lion has not improved as much as you hoped 

The injection your vet suggested is Hydrocortisone, a corticosteroid. This is a commonly used steroid injection.


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## Cazzer (Feb 1, 2010)

sorry to hear Lion's not so good x


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## Ianthi (Oct 21, 2008)

voxie said:


> Hi all,
> 
> Just to update...
> 
> ...


Hi Voxie,

Sorry to hear the fluids didn't succeed in getting the levels down any further but as you know I've always suggested that something else was a play here _but_ I'm not convinced it's lymphoma either based purely on what the ultrasound showed. For one thing with lymphoma usually both kidneys are affected, not just one! Also do bear in mind the *only* way to definitively diagnose this is by a biopsy! Whether or not a kidney *looks* as if it has lymphoma is neither here nor there at this stage - the vet doesn't actually *know* for certain. Even with a vet who is skilled in sonography ( ultrasound ) - and most general vets aren't - a biopsy is *always *needed for confirmation! Another factor is that with lymphoma I would expect Lion to be far more ill and as you know he isn't. I've heard of cases where lymphoma was actually diagnosed even after biopsy when it was actually pyelonephritis ie a kidney infection. It happened to someone on Tanya's site as well - in her cat's case both kidney were affected. Have you signed up yet? She still posts.

There are other reasons for one kidney to be more enlarged such as infection ( and remember Lion was never treated for this and it requires a 4-6 week course of antibiotics ) and crystals which cause blockages. Nephritis is another possiblity. I think you should rule these out first before considering other possibilites here especially something like lymphoma which requires a more definitive diagnosis by a veterinary pathologist!

Even if it is lymphoma, which I seriously doubt I wouldn't give up without trying chemotherapy. The response rate in cats is quite good with cats achieving remission quite quickly and unlike humans the doses are soo small, they don't have the same side effects. With this treatment the renal problems would then resolve themselves.

Do keep us posted! And good luck

When is Lion due home?


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## voxie (Jan 16, 2011)

Hi all,

Thank you for your lovely comments xx

I saw him at the vet and gave him lots of cuddles. He seemed almost like another cat when left alone though, dazed and stuff... For the passed couple of days, he's not eating very much, however, he is drinking a lot, despite being on the drip. It seems any liquids are just going straight through him, and his kidneys aren't processing it at all. He was doing so well on the weekend though, so this is just shocking.

Ianthi, the vet has now confirmed he had abnormalities in both kidneys.  And with it's structure, is most likely lymphoma. John (the vet) says it looks like it's in the 2nd stage, the next stage would be spreading to other organs...

The vet's recommended leaving it until tomorrow afternoon until another blood test is taken, to see if the Hydrocortisone (thanks BSH) has made any difference.

Will see how it goes from there. Other options are chemotherapy and perhaps a biopsy - however, Lion would have to be very heavily sedated, and the vet seemed unsure if this is wise with Lion's condition. He seems worse than when he arrived on Saturday! After seeing him like that..... I am preparing to accept the first option in this thread title..... It was really hard to even get him to look at me for the attached pic. So we'll see how it goes... xx


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## Petloversdigest (Dec 10, 2010)

So sorry Voxie to hear that Lion is so poorly, thinking of you throughout this time of worry.


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## Ianthi (Oct 21, 2008)

Hi Voxie,

Really sorry to hear the visit was upsetting and sad to read Lion had gone downhill. I'll be praying the hydrocortisone will make a big difference though!

I'm very cross you're vet didn't do an ultrasound at any earlier stage because if he's saying he's fairly sure it's lymphoma ( though as I said before he can't be certain ) you've essentially been only 'firefighting' and treating the symptoms rather than the disease for the last month and treatment could have been instigated before now and things has progressed to this stage. Renal lymphoma normally responds well to chemotherapy! I'm not saying it's too late now but obviously the earlier treatment is instigated the better. As I mentioned in one of my first posts the very high numbers Lion presented with usually point to acute renal failure and renal lymphoma falls into this category! So the pointers were there! Also the fact you did request an ultrasound makes this even worse!

I've always bypassed vets' 'ruling out' method of diagnosis accompanied by the 'We'll try this first' approach because frankly it has never made any sense to me, by insisting we have a correct and accurate diagnosis right from the beginning! How on earth can you treat a condition successfully if you don't essentially *know* what is actually wrong in the first place?

With this elimination process, valuable treatment time ( and money ) is wasted targeting other illnesses/symptoms while the *real* condition remains unaddressed and is of course by now in more advanced stages - very often making it even more difficult to treat than if caught early! I had to have a real battle with one of my last vets to have my cat X-rayed because I wasn't convinced the urinary blockage he suffered was due to stress-he was such a laid back cat- and when he finally relented and had one done, a huge bladder stone was revealed! After that ( I didn't stick around long! ) he was always very sheepish with me!

Of course Voxie don't forget that with infection the kidneys are also enlarged and ( in the absence of an alternative, confirmed diagnosis ) I would strongly suggest starting Lion on Baytril which is one of the most effective antibiotics for this and see if there is any change before considering anything final!

I really do hope Lion improves with the steroid! Fingers crossed for you and Lion.


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## debbie29 (Feb 6, 2011)

Just read through your post. Really sorry to hear your little man is so poorly. My thoughts are with you and I've sent a special cuddle Lions way
x


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## voxie (Jan 16, 2011)

Hi there all, thank you again for your nice comments - sorry for not updating sooner!

*Thursday 17th February*
A remarkable improvement in Lion's behaviour today! It looks like the hydrocortisone is working. Upon visiting him, he was interacting with me a lot, and even wanted to jump up out of the cage, more curiously up the cage door and above it for some reason, hehe (see pic). He's lost more hair around his neck though, where they've taken blood... but still handsome!

The doctor explained that the hydrocortisone is certainly kicking in. His next suggestion was to give him 2 tablets to boost this. These tablets he referred to as chemotherapy tablets, and began with an L... can't remember the full name.

I suggested the baytril mentioned here - which the vet had heard of before. However, he said that if the baytril isn't concentrated properly (in Lion's case. via the kidneys), it can cause blindness in cats. So baytril was a no-no here.

Biopsy is a possible option, however Lion is not in a great state to be put under right now. I explained that I would like to know 100% that this was lymphoma and not an infection - I also told him I had been blogging his progress online, and this was recommended by people there. I also mentioned that someone had recommended me a renal expert at the Royal Veterinary College. The vet said he would be more than happy to refer me, if that's what I wanted. However, in Lion's condition, he'd be shocked and concerned if they agreed to operate on him for a biopsy - and even then, it would cost me at least £1500.

I felt unsure about a referral right now, especially as Lion seemed happier today. Also this vet gave me the choice to pay bills in installments - I doubt the Royal Veterinary College would allow this.

The vet said he will give the 2 tablets tomorrow and see how he gets on. He recommended I came by Saturday.

I left the vet glowing, as I was happy (in contrast to yesterday) in seeing Lion get some glow back. 

*Friday 18th February*
I only had a few minutes to see Lion today, as they were closing up. He looked dismal, sitting upright in his cage, staring back at me. He really needs to come home!

*Saturday 19th February*
Arrived at the vet's at 9:45 and didn't leave until near 13:00 as they were so busy (I hadn't an appointment officially booked)! I bide the hours with Lion in the cage room, cuddling and petting him, observing him. He wasn't as energetic as he was Thursday, but would interact when encouraged to. He was drinking a lot and having a few biscuits. But he looked like he really needed to get out of this place - he'd been in there exactly a week today.

The vet popped in and said he had taken a urine sample around 7:30 that morning. Concerned about my comments on Thursday, he told me there was no sign of protein or blood in his urine, thus no signs of infection, and that it is 9 out 10, lymphoma. In response to other infections, he also said that Lion is a male, and when do you ever hear of cystitis in males? He took another urine sample shortly after this. This later read to be clean, but with a 0.1% of protein - the urine sample before was clean, so the vet says he won't think anything of that.

After much stroking and peacemaking (keeping Lion from hissing at the other cat in the cage below him!), the vet had a longer chat with me and I was allowed to bring Lion home! 

He assured me that I'm welcome to have him referred elsewhere for a biopsy, but he won't do it himself with Lion's current condition. I am to give him home TLC and see how it goes until Tuesday. If the kidney numbers shoot up again, the vet recommends that putting Lion to sleep should be seriously considered. He also gave me a copy of today's bloodwork (attached) - and he said he's not a vet to treat the numbers, but the patient. The creatinine has come down a great deal from the 600s. now down to the 300s!

But Lion's state to me, is _dismal_, almost like he can't be bothered anymore, as if he's had enough... And this concerns me. I don't want to exhaust him anymore... however, it's hard to tell anything right now, as he's been at the vet for days. Maybe that's why he's miserable...

I'm home with Lion now, and he is cozy and purring. He has a little bit of a shiver though - the vet says this is likely the high urea levels in his kidneys. Also, he's not eating - as he was back in the vet. I'm hoping this is just because he feels a little disorientated still...

Will see how tomorrow goes... xx

*Lion's state today: *Seems depressed. Purring, cuddly, but shivering every now and then. Hardly eating, but drinking.


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## Ianthi (Oct 21, 2008)

Hi there!

I'm really really glad to read about Lion turning a big corner here! Also happy he's home - a stint at the vet's can be hard on kitties and it's likely he's very tired and needs recovery time at home! Do persist in getting him to eat though.

The chemo drug you mentioned is Elspar and the fact he's responded so dramatically to both this and the steroid ( although at this stage it's difficult to pinpoint which drug exactly induced this massive improvement ) resulting in this huge reduction in creatinine from 600 to 375 is absolutely fantastic in my opinion! In view of this, without further treatment and investigation, I do NOT understand why he's suggesting PTS - it's ridiculous! I wouldn't dream of giving up on him at this stage, especially when traditionally renal lymphoma responds very well to chemotherapy! And Lions' response is very promising indeed though I've no doubt the drugs need fine tuning! Furthermore a cat who is climbing up the cage and hissing at the next occupant doesn't sound to me as if he's ready to go!!

The one thing I cannot stress enough is that your vet needs to consult with a veterinary oncologist asap who will suggest the correct chemotherary protocol-the correct combination of drugs and their dosage to ensure the most succesful outcome here! Chemotherapy treatment is usually beyond the remit of general vets - and it's the norm to look to a specialist. In order to maximise Lion's chances-and most probably a better choice of drugs will ensure this - he needs to do this right away! In this case you won't need to refer him yourself either.

I hadn't realised your vet would go ahead with the chemo in the absence of a definitive diagnosis - some won't - hence my original suggestion. So this is good news! In view of the good response you don't need to pursue this for the moment. The main advantage apart from confirmation, is the results ( whether it's small or large cell lymphoma ) are used to inform the correct chemo protocol necessary for treatment. A fine needle aspirate biopsy is all that's usually required for confirmation not a full biopsy sample which is more invasive and not recommended for kidneys that are already compromised! So your vet is right here. Incidentally with small cell lymphoma the the drugs can be administered at home!

With kidney infections ( though it's doubtful at this stage ) it's quite common for bacteria not to show up in the urine sample but nevertheless I'm glad to hear your vet is at last ruling out this possibility! Such a pity he didn't pursue this diagnostic side of it before though!

When is Lion returning to the vets? What medication is he currently on. Of couse without continuation of the medication he will deteriorate so bear this in mind when assessing his conditon!


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## voxie (Jan 16, 2011)

Hi all 

Sorry for slow updates!

I'm happy to say that yesterday, Lion was very well! In contrast to Saturday, he was eating and drinking as normal!! I was happy to find his bowl empty on Sunday morning. Seeing this has made me very happy. _But for how long?_ That's the dark question...

Also, I forgot to mention he has been on the antibiotic injection since 12th Feb - this apparently lasts for two weeks. He's also had his happy pill on the Saturday just gone, to be given every 3 days.

Will post again soon xx


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## Ianthi (Oct 21, 2008)

Really glad to hear this Voxie - have been wondering about you two!

What pills is he currently on then?


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## Kels (Feb 21, 2011)

I am so sorry you and Lion are going through this, they mean the world to us. What you have written will be very useful for so many others, thankyou.
I hope Lion is feeling good today.


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## Cazzer (Feb 1, 2010)

glad to hear he is still with you x


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## Petloversdigest (Dec 10, 2010)

voxie said:


> Hi all
> 
> Sorry for slow updates!
> 
> ...


I wonder if the chemo knocked him for six and he is now coming out of the after effects of that. Happy news if that is so. Keeping my fingers crossed, as always.....


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## voxie (Jan 16, 2011)

Hi all,

Some bad news - Lion had a blood work test yesterday, and his Creatinine has shot back up to the 600s. This isn't a good outlook...

I'm now going away on holiday (for just a week luckily) and will be leaving Lion in care of my parents. He has 3 vet appointments scheduled until I get back, but obviously I can't post here... However, I will be keeping in touch on phone to check on how he's doing.

I hat to type this, but.. The vet has warned me that Lion may not make it before I came back..... So I briefed him on how I would like him put down. Hopefully, this won't happen, but he said it'd be good to know just in case.

Will post again in a week's time. My finger's are crossed for my boy xx

*Lion's state today:* Sleepy, losing weight. Eating and drinking as normal, despite the kidney numbers...


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## Petloversdigest (Dec 10, 2010)

Will keep everything crossed for Lion whilst you are away - I wish you a peaceful week too.


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## Ianthi (Oct 21, 2008)

Have you vet spoken to on oncologist yet? Considering the response to chemotherapy (with renal lymphoma ) is usually excellent, it sounds as if your vet isn't using the correct protocol here. I think I pointed out before chemotherapy is beyond the scope of most general vets! 

Alternatively considering you don't have a firm diagnosis here the weaker response could be due to another condition ie infection!

It is a very good sign Lion continues to act well despite the numbers so I wouldn't consider anything irrevocable until I'd investigated all the above first!

Have you posted on the lymphoma board? There are a few cases of renal lympho which are now in remission-a few years post diagnosis! Last time I was there they had posted a few responses with good advice for you but you may not have noticed them.


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## voxie (Jan 16, 2011)

Hi all, ^^

Unfortunately, it's not good news. I arrived back from holiday yesterday, and was scared... but happy to find that Lion was still alive! He is however, very skinny and dehydrated. My parents say that he had been eating while I was away, but by the sounds of it, not a lot.

Since I've arrived though, he hasn't eaten anything, only drinking. But his Mirtazapine is due. He also had a red bump on his back - the vet said this is a reaction to the injection there (he was given the antibitotic last Friday). I also noticed him scratching it with his back leg! I think this may have aided the issue, so I bandaged over it right away to stop it.

He hasn't been very sociable either. He's very dismal, looking as if deep in his own thoughts. I can't help but think he's had enough and is just waiting to leave us... The general outlook is quite poorly, to say the least. He had jumped up on me to rest though, he seems happy to see me.  Having been very jet lagged, we took long off-on naps together.

This morning I took Lion to the vet, having sat in the waiting room for over an hour patiently. Lion was meowing a lot more than usual, and looked/felt very dehydrated. On bringing him to the vet table, John shook his head, saying this is end stage kidney failure. He got me to smell his breath, which smelt of urine. This is how high the urea has become, he said, and believed it to be in its 1000s.

He's given him a shot of Hydrocortisone and a dose of Mirtazapine. But has advised that if his condition doesn't improve _*in the next 24 hours*_, to have him put down tomorrow...... 

Ianthi, I believe the vet did contact an oncologist initially when Lion was diagnosed with lyphoma - I think that's how he came to that conclusion.

*Lion's state today:* Dazed, not very social.


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## thelioncub (Feb 9, 2009)

Hey you,

I've only read your first and last post so I don't know all the details, but I just wanted to say that we were in the exact position re: CRF with our Merlin - who incidentally looks very much like your little man (she's on the far right of my sig). Every time we went away I was scared she wouldn't be alive when we got back.
She suffered with CRF on meds for a couple of years and we tried everything possible. We finally reached the worst of it when our vet said that she would need to keep Merlin in overnight for treatment that could only be effective for a day or so. Everything they tested was off the chart, and Merlin's pee was clear (not a good sign).
Deep in my heart, I knew it was the end.
She was weak, disinterested in everything, kept falling over and pee-ing herself. I once even found her lying with pee at one end and sick at the other - This broke my heart.
I decided to say goodbye, and had her at home for a day to have that last bit of time with her - She was surprisingly happy on that day, and was much more responsive. Although part of me kept thinking 'maybe I should change my mind and hold on that bit longer', I KNEW it wasn't the right thing to do, and actually felt that Merlin was perking up because she was happy it would be over soon. 

All I can say, is that you honestly know when it is time, and as sad at it is - it is the right decision to make when you can see your little one suffering. 
I would hate to be in your position again (even though I now have to expect it with Merlin's son, Lancelot - who very likely has Cancer) but I am going to remind myself to keep remembering what Lance is like when he is happy - and ask myself 'is he like that now?'
When the answer is 'no', I think it is time to let go.

I'm so sorry hon.. I appreciate how hard this is.
*hug*


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## Petloversdigest (Dec 10, 2010)

My thoughts are with you today, Voxie.


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## moandben (Jan 27, 2010)

Thinking of you today xxxx


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## Cazzer (Feb 1, 2010)

thinking of you both x x


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## Ianthi (Oct 21, 2008)

How is Lion now Voxie?

Was he on any medication while you were away? Which ones? 
Did the vet give him any fluids yesterday because it sounds as if he needed them and I would be surprised is he didn't suggest them.
Do remember if he's not responding well to the current chemo protocol that's it's very possible he will do so if different ones are tried.

Sorry a lot of question but I'm trying to work out here why his response hasn't been that good!


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## voxie (Jan 16, 2011)

Hello everyone,

I apologise for the delayed response. Lion tragically passed last Friday at around 12pm.

It was when I was just finishing my last post above, that Lion's behaviour changed drastically. I had to rush him to the vet, where he was eventually put to sleep.....

I was typing on my PC, with a clear view of Lion on my bed behind it, so I could keep an eye on him. He was resting on my quilt for about 15 minutes. Then he walked over to the pillow, where he sat in the sphinx position, his back to me. He then started meowing, quite loudly as if calling for me or if in pain.

I rushed over to him, calling him. He attempted to turn to look at me, and meow slightly. He was obviously in great discomfort! I panicked and called the vet. Lion's vet John had left for the day, but to bring him in right away. I knew deep down in my gut that this was it... Lion was crashing.

I got to the vet in about 10-15 minutes, by bus. Lion was meowing a lot. I kept opening Lion's carrier to check on him, and he kept wanting to jump out... he almost escaped at one point! On arriving at the vet, to my surprise, John had come back on alerted that Lion was being brought in. I was so thankful for that.

I let Lion out of his carrier, and he walked unsteadily from the vet's table to the countertop. He sat in the sphinx position again, face to the wall. He was very uncomfortable and stressed. I tried picking him up, but immediately he fought out and returned to that position. The vet and I knew it was time. My brother came as well, as I couldn't deal with this alone.

Remembering what Tanya's site, it said that the method would be fluid therapy. But Lion has had this twice already, both times were difficult. Looking at him, I knew he'd had enough. So he was put down... I held my head to his and cried so much.... the vet and his assistant kindly left me and my brother alone. Lion looked so peaceful lying on the table now. I realise that I hadn't seem him look so peaceful in a long time, and that it would have been cruel to let him put up with it any longer. The warmth was leaving his body... I couldn't believe he was gone. But I found strength in my decision, that he and I were now relieved.

I want to thank everybody on this forum who offered their kind words and advice. I really don't have the words at the moment, so I put a collage together.

Many thanks again, and I'll be sure to return to offer help to other cat lovers. I won't be getting another cat I don't think, it's just far to painful saying goodbye (Lion was my first pet to see to the very end).

It's so strange that this happened the day after I arrived back from my holiday as well. I'd like to think he waited for me, but another part of wishes I could have spent that extra 7 days with him.

*Lots of hugs round to you lovely, caring people xxx*









(Larger version)


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## momentofmadness (Jul 19, 2008)

RIP Lion.. 

I believe he did wait for you.. 

My mum said that about one of her cats.. And I believe its true.. 

Your pictures are lovely he was a stunning cat.. Big hugs too you.. xxx


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## Elsbells (Feb 18, 2011)

What a lovely tribute, and such a beautiful boy.

I've been through this myself in almost identical circumstances, so I know there is little I can do or say to ease what you're going through right now.

All I know is that Lion is incredibly lucky to have had such lovely caring person looking after him all this time and I'm sure he knew that too.

Nothing can replace him, but I hope you are feeling much better very soon, and I expect you'll have so many great memories of Lion.


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## Ianthi (Oct 21, 2008)

Dear Voxie,

I'm really sorry to hear about Lion. You crossed my mind today actually. 

Yes, he was indeed a gorgeous boy! What a lovely tribute to him!


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## voxie (Jan 16, 2011)

Thanks all for your lovely comments... He was indeed a very handsome cat. It was also his nature as a cat... he was so human in expression, never annoying, always lovely to be around. I'm sure it was the same with his case.

He'll always be remembered as pretty much, my only pet in the world xxx


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## Petloversdigest (Dec 10, 2010)

Thinking of you Voxie, in your hour of need - I'm sure you did the very best for Lion and he was a special boy who was so lucky to have chosen you for his best bud. RIP Lion


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## Cazzer (Feb 1, 2010)

sorry to hear about Lion x x


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## BSH (Jul 28, 2010)

Sorry to hear your sad news but he is at peace now.

Run free Lion.


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## Sushi's Mummy (Oct 13, 2010)

Sending you hugs during this difficult time. What a wonderful tribute. RIP gorgeous, handsome-faced Lion. 

I also beleive he did wait for you Voxie. He wanted to say goodbye to his loving, caring owner with whom he shared a happy life. xxxxx


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