Tuesday, March 11, 2014

home with with cats

i'm still so sick.  i'm completely over it.  i had to call into my intership today, which i hate doing.  but it's like every morning i've woken up and felt worse.  i went to urgent care on sunday and got some antibiotics and flonase and whatever.  the doctor said it's an upper respiratory infection and i'm so over it.  i'm going to see my rheumatologist tomorrow to talk about starting a new biologic medication - of course, i won't be able to start until after this stupid plague is done.  humira is most likely next on the list.

samantha has been snuggling with me a lot.  jake has HATED piglet since she came home from the vet on friday with her saddlebag of saline (cats get like a lump area where the fluid collects after received subq fluids.  it gets absorbed over a couple of hours).  every time he saw piglet, jake would just start hissing.  now she can sometimes get close to him, especially at feeding time, before he starts hissing.  i'm not sure what to make of it.  at first, i was like, maybe she smells like the vet or like alcohol - i remember one time when samantha went to the vet, piglet hissed at her for a day or so and sammy had blood drawn, so she smelled a bit like rubbing alcohol.  but it's been like four days, jake, calm the fuck down.

but then i think, what if jake can tell something big is wrong?  what if now he knows that piglet is, like, dying or something and he's scared?  what if her aura has changed and jake is sensitive to that?

or what if jake is just a huge fucking asshole of a cat?

anyway, we have antibiotic pills that we have to give piglet daily.  amoxicillin, 50mg.  it's not easy to pill a cat.  but we're working on it.  i've also done some food research with the help of a friend who owns a pet store and has some friends in the know.  i wanted a kibble that is okay for all of the cats because it's hard to keep them out of each other's kibble - they don't always eat it all at once.  when i feed them wet food, i watch them so it's easier to keep them separated.  we decided on a wellness kibble with high quality protein sources, but it has grain.  i'm not thrilled because jake seemed to be doing very well on grain free.  we'll see what happens there.  as for food, right now sammy and jake are going to finish up some of the freeze dried raw we have and for piglet we have a couple of cans of iams and purina kidney diet.  i'm hoping to order a couple of cans of royal canin's kidney diet too and see which piglet likes.  she's actually eating most of the iams, so that's something.

the problem is breakfast and nighttime snack - we don't always watch them.  so nighttime snack is kibble and for now breakfast is too.  once i'm not sick any longer and am waking up early again, the cats will probably get a quality wet food, not prescription.  i know so many people are like 'but your cat needs prescription food, that's what the vet says'.  and i totally respect the vet's advice.  as intent as i have been feeding raw, it's not good for all cats and i understand that now.  sammy and jake seem to be doing okay on raw, but it's like i don't know what to do.  we fed taylor whatever crap food and he developed kidney failure.  we put him to sleep three years ago last week - on march 8.  piglet was diagnosed march 7.  annoying and kind of creepy.  but i kept him alive for about 5 years on a diet that i figured out, and it did not revolve around prescription foods.  yes, we fed him the iams rx canned food for a few months, but as i learned more i changed what we fed them.  for the last two or three years of his life, he did not eat any rx food.

meanwhile, piglet has had good or premium quality food from the age of 1.  i have always tried to do the best by her.  and she developed kidney failure about two years younger than taylor did.  and her kidney failure is more progressed than his.  based on the numbers i'm seeing and some comparative googling, she's lost like 80% of her kidney function.  taylor's numbers were never this high.  and we got them lower over time by adjusting his diet.  plus let's add in the whole blood and pus in the urine. could that be a raging kidney infection?  sure.  could it be a thousand other things like cancer (that's how we discovered nibbler had lymphoma - blood and pus in the urine)?

and of course, now piglet's tooth has to stay put.  no idea what it actually is - the vet won't say it's feline odontoclastic resorption, but also mentioned that it looked like it could be something worse and wanted to biopsy it.  piglet is still hungry and purry and snuggles with me a bit - but she seems lethargic.  her breath is horrible - worse than normal cat breath.  and it's not like i don't think piglet is worth spending money, but i think there's a limit.  especially now that i know she's in kidney failure.  is it worth extracting the tooth for her comfort?  of course.  is it worth doing a biopsy on the gum to see if it's cancer or something?  maybe not.  it's a couple hundred dollars and it doesn't fucking matter - she. is. in. kidney. failure.  taking out the tooth isn't going to fix this.

there is no cure for this, only treatment.  only ways to try and help her kidneys function as best as possible for as long as possible.  this could easily include subq fluids at home.  how long is piglet going to like that?  how are we supposed to know when enough is enough?  it's so hard.  i don't want to seem like one of those people who just randomly puts cats to sleep because they cost too much - far from it.  i am one of those people who randomly puts animals to sleep when their quality of life declines to a point.  i called around to numerous vets when we were moving to florida to put a dwarf hamster with a tumor down.  the stress of the drive alone would have been enough to give a dwarf hamster a heart attack (literally, not figuratively).  i finally found one who was willing to try since there's no like vet-approved amount of sleepytime drug to put a dwarf hamster down.

cats are notorious for not letting people know things.  like when they hurt.  taylor could have been in pain for days, weeks even, before the day he went downhill quickly.  cats don't just purr when they're happy - they purr when they're in pain to comfort themselves.

i have this love/hate relationship with the web.  it helped me learn about feline kidney failure and helped me find new things to try.  it helped me discover feline herpes and enabled me to work with my vet at the time to treat it.  but it also shows me a list of things that say 'your cat is sicker than you think'.  piglet has numerous signs that put her at last stage 3 or possibly stage 4 kidney failure.  most vets recommend euthanizing cats in stage 4.  can piglet afford to wait a month on this food without subq fluids to see if her numbers stabilize?  how much more aggressive should we be?  so many questions with no good answers.

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