Tanya, Thomas and Ollie were three of our cats, all
of whom developed CKD.
Although they did all eventually die of the disease,
their experiences and quality of life throughout the illness were very
different.
Tanya's Story
Tanya was a Blue Persian who came to live with us at
the age of ten weeks. She was a happy cat who enjoyed good health,
although she was rather small (she averaged around 6lbs for most of her
life) and quite timid. Her only real health problem was the occasional tooth abscess which
required removal of the offending tooth — she had three of these over the
years.
When she was twelve years old, Tanya went for her annual vaccinations and
check-up. Earlier that year her coat, previously beautiful and glossy, had
become dry and was showing signs of dandruff which the vet had ascribed to
her advancing years. During this visit the vet thought she might have the first signs of CKD but
said there was nothing that could be done at that stage — she
could manage another five weeks or five years. We were very upset but
Tanya seemed stable and we naturally were hoping that she would manage
five years.
A
month later, at
the end of October, Tanya and I returned to the vet because she had
lost more weight and her spine was very prominent and bony. This time we
saw a different vet and blood tests were run and the vet told me Tanya had CKD. She felt Tanya had
less than a year to live — I was heartbroken. We were given steroids and
antibiotics and a therapeutic kidney food as treatment.
Tanya went downhill fast. She soon lost her appetite and lost a lot of
weight. She had very bad mouth ulcers and muscle weakness; there were
also signs of a heart murmur. We syringe fed her on particularly bad
days. She was obsessed with drinking water, preferably from a
sink. Unfortunately, we were not really giving her any treatments. The
only thing we did was to offer her a therapeutic kidney food, which she would not eat. We did not know other
treatments were possible. I was not online at the time but I called
breed rescue centres, holistic pharmacies, anyone I could think of, but
treatments in the UK were in their infancy and nobody was able to
suggest anything else. I don't know if treatments would have prolonged
her life, but they certainly could have made her more comfortable.
Tanya rallied and made it through Christmas (when she enjoyed her Christmas turkey) and
the New Year; by this time she was receiving steroid injections from the
vet every other day. On 10 January, we realised Tanya was suddenly
unable to urinate; her kidneys had completely seized up. The vet kindly
came to our home and put Tanya to sleep. Tanya was buried in the garden
she loved so much; she only weighed 3lbs when she died, having lost half
of her bodyweight. We were completely
heartbroken.
Thomas's Story
Thomas,
a black domestic shorthaired cat, was the local stray, who was already
in the neighbourhood when we arrived. Tanya would not allow Thomas in
her garden and he used to run away from us if we tried to get near him,
but our next door neighbour used to feed him every day. She told us he
was feral and that she could not get near him either.
Five years
later our neighbour told us she was moving into sheltered housing and
could not take Thomas with her. We decided to try and trap Thomas and
tame him if possible so that he could have a proper home. It took more
than a week (he was very wily!) and during the attempts I noticed that
Thomas had an overpowering aroma.
We caught
Thomas and took him to the vet where they discovered that the smell was
coming from severely abscessed teeth; he had three removed. Apart from
that, he was basically healthy — his kidney values were very slightly
elevated but my vet ascribed that to the stress of being trapped and his
dental problems, and they reverted to normal later on.
We soon
discovered that Thomas was not feral, our vet determined that he was
already neutered and had had dental work performed in the past. Thomas
loved living with us and settled in well. In November, however, he had
an accident which required surgery, and during the pre-surgery blood
work my vet discovered that Thomas's kidney values were sky high. She
recommended a special therapeutic kidney diet and regular steroid injections
every three-four weeks.
Thomas had
his first steroid jab in early December. He refused point blank to eat
the therapeutic kidney food but he acted perfectly normally, showing no
signs of illness whatsoever, until the weekend of 18/19 December.
On the
Saturday, Thomas went off his food a little, though he did eat some fish
in the evening. On the Sunday he refused to eat and by the evening he
was also refusing to drink; he sat hunched up and his breath had a
distinctive and unpleasant aroma. Basically, he had
crashed,
so we should have taken him in over the weekend as an emergency, but I
didn't know then that his behaviour constituted an emergency.
We went to
the vet as soon as the clinic opened on Monday. Thomas was severely
dehydrated and my vet put him on intravenous (IV) fluids — a drip — in the
hospital. She tested his blood and the numbers were incredibly high. His
urea was 86 mmol/L (US: BUN 241) and he was also severely anaemic (his PCV was
18%, but since he was dehydrated, it was probably much lower than that
in reality because dehydration makes PCV or HCT look higher than it
really is). She felt he would die if he couldn't be persuaded to eat;
and even if he ate it would be touch and go — she feared that once he
was off IV he would crash again.
We were not online when Tanya was ill but by this time we were, so I
went home and searched on the internet and found an online support group. The people there
recommended subcutaneous fluids once Thomas was home from the vet's. I
spoke to my vet who was initially rather sceptical about the idea but
eventually she agreed to teach me how to do them for home use.
Thomas had IV
treatment for four solid days and nights, yet sadly his numbers did not
fall; his urea was still 86 mmol/L (US: BUN 241 mg/dl). However, he had at least
begun to eat a little, so he came home on Christmas Eve, and he ate well
and seemed reasonably healthy. Unfortunately I got the 'flu over the New
Year and was unable to give him any fluids, with the result that he
crashed again and was put on IV once more on 6 January, this time for
three days.
After Thomas
came home, his anaemia was really severe and he was very weak, and he
would only eat ham. We persevered with some of the treatments we learnt
about, including daily sub-Qs and regular
ESA treatments in the form
of Exprex; and by mid February he was doing really well. His blood work
results improved, so he was now considered to be a "medium numbers
kitty" (his creatinine level was 3.47 mg/dl). Thanks to Eprex, his
anaemia was completely under control. He ate well, groomed himself, went
out for walks and to look at him you would not have known he was ill.
Thomas did
well for several months. At the end of July, we took him to the vet for
a routine check up. We were shocked to discover that his creatinine
level was now 650 µmol/L (US: 7.3 mg/dl) — he was exhibiting no signs of illness at
all. His anaemia had not returned but his phosphorus levels were too
high, even though he had been on phosphorus binders from the start.
Thomas
suddenly crashed on 10 August and we made the painful decision to let
him go on 11 August, when it was apparent that this time he could not
fight back; like Tanya, he was unable to urinate. The vet came to our
home and helped him cross — it was very peaceful. He had been acting
like a healthy cat right up until 10 August, even going out for a long
walk on 9 August and returning to eat a large dinner (Thomas's appetite
was always pretty good apart from when his anaemia was severe). Although
it was a shock for us, I am glad for Thomas's sake that he was able to
enjoy life right up until the end and that his last day was spent
looking out at the garden he loved.
Although we
miss Thomas terribly, there is no guilt. We know we did our best for
him, and he and we greatly enjoyed the eight months together we thought
he would not live to see. If I had known he would leave when he did (it
seemed so unlikely when I was creating the site), I would not have named
this site solely in Tanya's honour — Thomas taught me so much about life
and love, and about strength and not giving up. My vet said he was the
bravest cat she had ever known. Thomas also enabled me to learn all I
know about CKD, and this site is as much a tribute to him as it is to
Tanya.
Here's Thomas
five months after his crash (he did have ears really, but my camera was
broken).
These
pictures of Thomas were taken about one week before he died. I think
they show how well a cat receiving treatments can look and feel, even
towards the end.
Ollie's Story
Ollie was a cream Persian, like our first male cat,Harpsie. A
family member was so smitten with Harpsie that he went to the shelter to
adopt a cream Persian and ended up with two, Ollie and his mother, Cleo.
Ollie was treated successfully for mammary cancer when he was thirteen and
made a good recovery, but the following year was full of changes. Firstly, his mother, Cleo, died of cancer,
and Ollie had to get used to being an
only cat for the first time in his life. Then his human moved to be with
his fiancée, so Ollie also had to move to a new home and get used
to three new humans, including two children. The children loved Ollie, but
he had never lived with children before. And the fiancée didn't like Ollie
much.
When Ollie was fifteen, his right eye had to be removed. He had suffered from
herpes for many years, and the eye just erupted. Ollie was very anaemic, but he made it through the surgery, and adapted to
living with one eye.
Unfortunately, two months later Ollie's human split up with his fiancée. He
had nowhere to live, and nor did Ollie. We offered to take Ollie in when
we returned from the USA. In the meantime, Ollie went to live for three
months at the cattery we used to use when we went on holiday.
When
we returned from the USA, Ollie came to live with us,
one week before his sixteenth birthday. The first time I saw him (left), he
was all blond and cute and fluffy. And then I picked him up. He was so
thin that I could put my (small) hands around his waist and they
overlapped! I could feel his spine, yet he ate like a horse. He was also
urinating and drinking a lot. I knew immediately that he must have a
medical problem. I booked an appointment with my vet for the next day.
That evening it became apparent that Ollie had additional problems in the
form of being very wobbly, vomiting, diarrhoea and pooping outside the
litter box. The latter was the main reason the fiancée hadn't liked
Ollie. Ollie was installed in our guest bedroom with puppy pads and
Catpaper all over the bed and carpet for easy clean ups. He seemed like a
very laidback kind of little guy, but then blond Persian boys do seem to
be like that.
Tests at the vet's the next day showed that Ollie weighed 5.3 lbs when in
the vet's opinion he should have weighed at least 8.5, and 9 lbs would
probably be his ideal weight. He had a heart murmur at level 4. He also
had CKD. His BUN was 80 mg/dl, his creatinine 2.81 mg/dl, his phosphorus 8.04
mg/dl and his
potassium 3.5. He was also anaemic, with PCV at 23%. Tests for an
overactive thyroid were sent to the lab.
Ollie's
biggest obvious problem was his weak back legs. He couldn't walk properly,
he twitched a lot, and while the vet was on the phone to me, poor Ollie
fell off the window ledge. I asked the vet if we could start him on a
potassium supplement. She didn't think it was necessary because his level
was exactly at the bottom of the range for the lab she used but she agreed
to let me give him one. After two days of the potassium supplement, Ollie
could walk normally again! Ollie was also given a phosphorus binder, B
vitamins and iron and a therapeutic kidney diet which he actually seemed to enjoy.
Surprisingly, Ollie's T4 (thyroid function test) came back as normal. Yet
he had so many signs of hyperthyroidism that I found this hard to believe.
So we did a Free T4 test, which showed that in fact, Ollie was indeed
hyperthyroid. We started him on medication for that too.
After
five weeks of treatment Ollie had largely stopped vomiting and having
diarrhoea and had gained 0.8 lbs. He was eating well and seemed happy — he
was a very placid, sweet-natured, cute little guy who loved his cuddles.
He got on pretty well with his new sisters, Indie and Karma.
Ollie continued to gain weight and enjoyed the summer. Eventually he got
up to 6.8 lbs, a great improvement on the 5.3 lbs he had weighed when he
first came to live with us. He developed high blood pressure but we were
able to control this with medication.
Unfortunately we struggled to control Ollie's anaemia. His HCT would go up
a little, then fall back down again. We discovered that his HCT had
actually been extremely low, only 18%, the previous year, but his vets at
that time hadn't even mentioned it to his human! So his anaemia was
chronic, yet we struggled to find the cause. My vet suspected cancer, but
Ollie was still too frail for invasive tests.
Towards the end of October Ollie went to the vet to check his blood
pressure and anaemia. His blood pressure was normal, but his anaemia had
worsened once again, from 23% to 18%. I asked the vet to trim Ollie's
claws since they were catching on things. Ollie collapsed! He had to be
placed in the oxygen tent to recover. The vet said he simply couldn't pump
enough oxygen around his body to cope with the stress he was under
because of the anaemia and heart issues. She said he was balanced on a knife edge.
Ollie
came home and seemed to be none the worse for his collapse. The photo to
the right was taken about a week later when he seemed fine (Ollie is on
the right, Indie is on the left). A couple of
days later, however, he seemed subdued, was grinding his teeth and was not
eating much, so the following day we went to the vet's. Ollie's HCT was
back up to 24%, which was encouraging. However, we found blood in his urine
so he had to go on an antibiotic.
Ollie seemed to improve somewhat on the antibiotic, though there continued
to be obvious blood in his urine. I was concerned about him and made an
appointment with the vet for 13 November. Sadly, on the evening of 12
November, Ollie suddenly collapsed. He was struggling to breathe and spent
the night in the oxygen tent. Tests on 13 November showed that Ollie's
poor little body was shutting down. He was in heart failure and his kidney
values had suddenly worsened dramatically, whilst his HCT continued to
fall throughout the day. His blood pressure kept falling. The vet said we
could try to help if it was his heart or his kidneys, but trying to treat
both conditions when Ollie was so frail would simply not work. The vet
helped Ollie to cross that evening, with us and his original human
present. He was gone within five seconds, so he clearly had given his all
and had no reserves left.
I still feel a bit cheated with Ollie. If only his original vets had
treated his anaemia and other health issues the year before he came to
live with us. If only he had
never got so thin with the undiagnosed hyperactive thyroid, which needed
additional tests for accurate diagnosis. If only we had returned earlier
from the USA
so he could have come to live with us sooner. But we did the best we
could in the circumstances, and I think he felt safe and happy and loved
with us. I miss my cute little guy.
TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE
EXTREMELY DANGEROUS.
I have
tried very hard to ensure that the information provided in this website is
accurate, but I am NOT a vet, just an ordinary person who has lived
through CKD with three cats. This website is for educational purposes
only, and is not intended to be used to diagnose or treat any cat. Before
trying any of the treatments described herein, you MUST consult a
qualified veterinarian and obtain professional advice on the correct
regimen for your cat and his or her particular requirements; and you
should only use any treatments described here with the full knowledge and
approval of your vet. No responsibility can be accepted.
If your cat
appears to be in pain or distress, do not waste time on the internet,
contact your vet immediately.
This site was
created using Microsoft software, and therefore it is best viewed in
Internet Explorer. I know it doesn't always display too well in other
browsers, but I'm not an IT expert so I'm afraid I don't know how to
change that. I would love it to display perfectly everywhere, but my focus
is on making the information available. When I get time, I'll try to
improve how it displays in other browsers.
This site is a labour of love, from which I do not make
a penny. Please do not steal from me by taking credit for my work.
If you wish to
link to this site, please feel free to do so. Please make it clear that
this is a link and not your own work. I would appreciate being informed of
your link.